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Li X, Eastham J, Giltnane JM, Zou W, Zijlstra A, Tabatsky E, Banchereau R, Chang CW, Nabet BY, Patil NS, Molinero L, Chui S, Harryman M, Lau S, Rangell L, Waumans Y, Kockx M, Orlova D, Koeppen H. Automated tumor immunophenotyping predicts clinical benefit from anti-PD-L1 immunotherapy. J Pathol 2024; 263:190-202. [PMID: 38525811 DOI: 10.1002/path.6274] [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: 07/01/2023] [Revised: 12/22/2023] [Accepted: 02/14/2024] [Indexed: 03/26/2024]
Abstract
Cancer immunotherapy has transformed the clinical approach to patients with malignancies, as profound benefits can be seen in a subset of patients. To identify this subset, biomarker analyses increasingly focus on phenotypic and functional evaluation of the tumor microenvironment to determine if density, spatial distribution, and cellular composition of immune cell infiltrates can provide prognostic and/or predictive information. Attempts have been made to develop standardized methods to evaluate immune infiltrates in the routine assessment of certain tumor types; however, broad adoption of this approach in clinical decision-making is still missing. We developed approaches to categorize solid tumors into 'desert', 'excluded', and 'inflamed' types according to the spatial distribution of CD8+ immune effector cells to determine the prognostic and/or predictive implications of such labels. To overcome the limitations of this subjective approach, we incrementally developed four automated analysis pipelines of increasing granularity and complexity for density and pattern assessment of immune effector cells. We show that categorization based on 'manual' observation is predictive for clinical benefit from anti-programmed death ligand 1 therapy in two large cohorts of patients with non-small cell lung cancer or triple-negative breast cancer. For the automated analysis we demonstrate that a combined approach outperforms individual pipelines and successfully relates spatial features to pathologist-based readouts and the patient's response to therapy. Our findings suggest that tumor immunophenotype generated by automated analysis pipelines should be evaluated further as potential predictive biomarkers for cancer immunotherapy. © 2024 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Xiao Li
- Genentech, South San Francisco, CA, USA
| | | | | | - Wei Zou
- Genentech, South San Francisco, CA, USA
| | | | | | | | | | | | | | | | | | | | - Shari Lau
- Genentech, South San Francisco, CA, USA
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Elfving H, Thurfjell V, Mattsson JSM, Backman M, Strell C, Micke P. Tumor Heterogeneity Confounds Lymphocyte Metrics in Diagnostic Lung Cancer Biopsies. Arch Pathol Lab Med 2024; 148:e18-e24. [PMID: 37382890 DOI: 10.5858/arpa.2022-0327-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 06/30/2023]
Abstract
CONTEXT.— The immune microenvironment is involved in fundamental aspects of tumorigenesis, and immune scores are now being developed for clinical diagnostics. OBJECTIVE.— To evaluate how well small diagnostic biopsies and tissue microarrays (TMAs) reflect immune cell infiltration compared to the whole tumor slide, in tissue from patients with non-small cell lung cancer. DESIGN.— A TMA was constructed comprising tissue from surgical resection specimens of 58 patients with non-small cell lung cancer, with available preoperative biopsy material. Whole sections, biopsies, and TMA were stained for the pan-T lymphocyte marker CD3 to determine densities of tumor-infiltrating lymphocytes. Immune cell infiltration was assessed semiquantitatively as well as objectively with a microscopic grid count. For 19 of the cases, RNA sequencing data were available. RESULTS.— The semiquantitative comparison of immune cell infiltration between the whole section and the biopsy displayed fair agreement (intraclass correlation coefficient [ICC], 0.29; P = .01; CI, 0.03-0.51). In contrast, the TMA showed substantial agreement compared with the whole slide (ICC, 0.64; P < .001; CI, 0.39-0.79). The grid-based method did not enhance the agreement between the different tissue materials. The comparison of CD3 RNA sequencing data with CD3 cell annotations confirmed the poor representativity of biopsies as well as the stronger correlation for the TMA cores. CONCLUSIONS.— Although overall lymphocyte infiltration is relatively well represented on TMAs, the representativity in diagnostic lung cancer biopsies is poor. This finding challenges the concept of using biopsies to establish immune scores as prognostic or predictive biomarkers for diagnostic applications.
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Affiliation(s)
- Hedvig Elfving
- From the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Viktoria Thurfjell
- From the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Max Backman
- From the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Carina Strell
- From the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Patrick Micke
- From the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
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Chen X, Chen H, Lin R, Li Y, Guo Y, Chen Q, Zhang Y, Cai G, Hu M, Chen G. Correlation between PD-L1 expression of the tumour cells and lymphocytes infiltration in the invasive front of urothelial carcinoma. J Clin Pathol 2023; 77:61-67. [PMID: 36319076 PMCID: PMC10804014 DOI: 10.1136/jcp-2021-207795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/30/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Programmed cell death-ligand 1 (PD-L1) as a cell surface glycoprotein can inhibit T cell function when binding to its receptor, PD-1. The newly developed therapy of targeting PD-1/PD-L1 signal pathway has shown great promise for the treatment of non-small cell lung cancer as well as melanoma. Approved by Food and Drug Administration, atezolizumab has become the first new drug to treat advanced bladder cancer. The aim of this study is to evaluate whether PD-L1 is associated with the lymphocytes infiltration in the tumour microenvironment and to assess the prognostic value of PD-L1 expression. MATERIALS AND METHODS Among 96 invasive bladder urothelial carcinomas, some were used to construct tissue-microarrays, and some cases with shallow infiltration or large heterogeneity were performed, respectively, for the following work. By means of immunohistochemistry and HE, PD-L1 expression and immune cell infiltration in the invasive front of urothelial carcinoma were analysed. RESULTS We find that PD-L1 expression in tumour cells and lymphocytes are significantly associated with more tumour infiltrating lymphocytes (TILs) and more T cells. The integrated TILs, T-PD-L1 and I-PD-L1 are not significantly correlated with the overall survival (OS) of patients. However, the combination of T-PD-L1 and TILs, T-PD-L1 and I-PD-L1 is significantly correlated with the OS of patients. The T-PD-L1 (-)/TIL (-) group show the best prognosis and the T-PD-L1 (+)/I-PD-L1 (-) group show the worst prognosis. Furthermore, a multivariate analysis reveal that PD-L1 expression of lymphocytes is an independent prognostic factor for OS of patients. CONCLUSIONS Our study reveal that PD-L1 of tumour cells are associated with the corresponding T cells infiltration and that the combination of T-PD-L1 and I-PD-L1, T-PD-L1 and TILs could be a relevant marker for the determination of the prognostic role of patients with the urothelial carcinoma.
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Affiliation(s)
- Xiaohu Chen
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hanbin Chen
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rixu Lin
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yulian Li
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ying Guo
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qi Chen
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanyan Zhang
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guoping Cai
- Department of Pathology, Yale University Center for Medical Informatics, New Haven, Connecticut, USA
| | - Mengjun Hu
- Department of Pathology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, Zhejiang, China
| | - Guorong Chen
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Yanagihara A, Yamasaki S, Hashimoto K, Taguchi R, Umesaki T, Imai H, Kaira K, Nitanda H, Sakaguchi H, Ishida H, Kobayashi K, Horimoto K, Kagamu H. A Th1-like CD4 + T-cell Cluster That Predicts Disease-free Survival in Early-stage Lung Cancer. CANCER RESEARCH COMMUNICATIONS 2023; 3:1277-1285. [PMID: 37476074 PMCID: PMC10355164 DOI: 10.1158/2767-9764.crc-23-0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/22/2023]
Abstract
Perioperative immune checkpoint inhibitors have been shown to improve prognosis in early-stage lung cancer. However, no biomarkers are known to indicate the requirement for treatment. This study aimed to identify T-cell clusters responsible for antitumor immunity in patients with early-stage lung cancer. Preoperative blood samples from 50 consecutive patients with lung cancer who were diagnosed as operable and underwent complete resection were analyzed by mass cytometry. Patients were divided into two groups: no recurrence at a minimum observation period of 851 days (median observation period: 1,031.5 days) and recurrence by the last observation date. Mass cytometry and single-cell RNA sequencing analysis of lymph nodes (LN) and tumor-infiltrating T cells were also performed. CCR4-CCR6+ Th7R showed discriminative ability between recurrence and non-recurrence patients with lung cancer. Patients with more than 3.04% Th7R showed significantly favorable disease-free survival. Th7R was a major component of CD4+ T cells in tumor microenvironments and LNs adjacent to lung cancer tissues and was the only cluster that decreased in peripheral blood after the removal of cancer tissues, suggesting that Th7R was primed and proliferated in tumor-draining LNs in the presence of cancer tissues. Th7R had the kinetics that antitumor T cells should have, as indicated by the cancer immunity cycle; thus, peripheral blood Th7R could represent the potency of tumor immunity by reflecting priming and proliferation in tumor-draining LNs and Th7R in the tumor microenvironment. Prediction using peripheral Th7R before surgery could allow the selection of patients who require perioperative drug therapy and optimize therapeutic interventions with clinical implications. Significance Peripheral Th7R, a Th1-like CD4+ T-cell cluster reflecting priming status in draining LNs and immune status in the tumor microenvironment, predicts disease-free survival after complete resection and has significant clinical relevance in selecting appropriate therapeutic interventions in patients with early-stage lung cancer.
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Affiliation(s)
- Akitoshi Yanagihara
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Satoshi Yamasaki
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Department of Clinical Cancer Genomics, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kosuke Hashimoto
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Ryo Taguchi
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Tetsuya Umesaki
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hiroyuki Nitanda
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hirozo Sakaguchi
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hironori Ishida
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kunihiko Kobayashi
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Katsuhisa Horimoto
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Koto-ku, Tokyo, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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Wolf JL, Trandafir TE, Akram F, Andrinopoulou ER, Maat AWPM, Mustafa DAM, Kros JM, Stubbs AP, Dingemans AC, von der Thüsen JH. The value of prognostic and predictive parameters in early-stage lung adenocarcinomas: A comparison between biopsies and resections. Lung Cancer 2023; 176:112-120. [PMID: 36634572 DOI: 10.1016/j.lungcan.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/11/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Since lung adenocarcinoma (LUAD) biopsies are usually small, it is questionable if their prognostic and predictive information is comparable to what is offered by large resection specimens. This study compares LUAD biopsies and resection specimens for their ability to provide prognostic and predictive parameters. METHODS We selected 187 biopsy specimens with stage I and II LUAD. In 123 cases, subsequent resection specimens were also available. All specimens were evaluated for growth pattern, nuclear grade, fibrosis, inflammation, and genomic alterations. Findings were compared using non-parametric testing for categorical variables. Model performance was assessed using the area under the curve for both biopsies and resection specimens, and overall (OS) and disease-free survival (DFS) was calculated. RESULTS The overall growth pattern concordance between biopsies and resections was 73.9%. The dominant growth pattern correlated with OS and DFS in resected adenocarcinomas and for high-grade growth pattern in biopsies. Multivariate analysis of biopsy specimens revealed that T2-tumors, N1-status, KRAS mutations and a lack of other driver mutations were associated with poorer survival. Model performance using clinical, histological and genetic data from biopsy specimens for predicting OS and DSF demonstrated an AUC of 0.72 and 0.69, respectively. CONCLUSIONS Our data demonstrated the prognostic relevance of a high-grade growth pattern in biopsy specimens of LUAD. Combining clinical, histological and genetic information in one model demonstrated a suboptimal performance for DFS prediction and good performance for OS prediction. However, for daily practice, more robust (bio)markers are required to predict prognosis and stratify patients for therapy and follow-up.
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Affiliation(s)
- J L Wolf
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - T E Trandafir
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - F Akram
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - E R Andrinopoulou
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - A W P M Maat
- Department of Cardio-Thoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D A M Mustafa
- Department of Laboratory of Tumor Immuno-Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - J M Kros
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Laboratory of Tumor Immuno-Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - A P Stubbs
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - A C Dingemans
- Department of Pulmonary Diseases, Erasmus MC Cancer Center, University Medical Center, Rotterdam, the Netherlands
| | - J H von der Thüsen
- Department of Pathology and Clinical Bioinformatics, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Laboratory of Tumor Immuno-Pathology, Erasmus Medical Center, Rotterdam, the Netherlands.
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NCAPH is a prognostic biomarker and associated with immune infiltrates in lung adenocarcinoma. Sci Rep 2022; 12:9578. [PMID: 35688915 PMCID: PMC9187691 DOI: 10.1038/s41598-022-12862-6] [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] [Received: 01/04/2022] [Accepted: 05/03/2022] [Indexed: 11/08/2022] Open
Abstract
Non-SMC condensin I complex subunit H (NCAPH) plays a regulatory role in various cancers. However, its role in prognosis and immune infiltrates in lung adenocarcinoma (LUAD) remains unclear. This study examined the expression of NCAPH in tumor tissues and its association with immune infiltrates and prognostic roles in LUAD patients. Patients characteristics were obtained from The Cancer Genome Atlas (TCGA). Integrated analysis of TCGA showed that NCAPH was overexpressed across cancers, including LUAD. NCAPH expression was verified by quantitative polymerase chain reaction and western blotting in 20 LUAD matched tissues. High NCAPH expression was significantly related to T, N, M, pathologic stage, primary therapy outcome and smoking status according to the Wilcoxon rank sum test. Cox and Kaplan-Meier analyses showed that the NCAPH-high group was associated with shorter OS. The PFI and DSS in the NCAPH-high group were significantly decreased. Multivariate analysis showed that NCAPH was an independent predictive factor for poor prognosis. Gene set enrichment analysis demonstrated that the G2/M checkpoint, ncRNA metabolic, memory B cells, KRAS, E2F targets and MIER1 process were significantly associated with NCAPH expression. Single-sample Gene Set Enrichment Analysis indicated that NCAPH expression was associated with levels of Th2 and mast cells. The impact of NCAPH on malignant phenotypes was evaluated by MTT, transwell, cell cycle and apoptosis assays in vitro. The malignant phenotype of LUAD cells was inhibited if NCAPH was knocked down. In conclusion, this research indicates that NCAPH could be a potential factor for predicting prognosis and a new biomarker in LUAD.
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Lin H, Pan X, Feng Z, Yan L, Hua J, Liang Y, Han C, Xu Z, Wang Y, Wu L, Cui Y, Huang X, Shi Z, Chen X, Chen X, Zhang Q, Liang C, Zhao K, Li Z, Liu Z. Automated whole-slide images assessment of immune infiltration in resected non-small-cell lung cancer: towards better risk-stratification. J Transl Med 2022; 20:261. [PMID: 35672787 PMCID: PMC9172185 DOI: 10.1186/s12967-022-03458-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/29/2022] [Indexed: 02/08/2023] Open
Abstract
Background High immune infiltration is associated with favourable prognosis in patients with non-small-cell lung cancer (NSCLC), but an automated workflow for characterizing immune infiltration, with high validity and reliability, remains to be developed. Methods We performed a multicentre retrospective study of patients with completely resected NSCLC. We developed an image analysis workflow for automatically evaluating the density of CD3+ and CD8+ T-cells in the tumour regions on immunohistochemistry (IHC)-stained whole-slide images (WSIs), and proposed an immune scoring system “I-score” based on the automated assessed cell density. Results A discovery cohort (n = 145) and a validation cohort (n = 180) were used to assess the prognostic value of the I-score for disease-free survival (DFS). The I-score (two-category) was an independent prognostic factor after adjusting for other clinicopathologic factors. Compared with a low I-score (two-category), a high I-score was associated with significantly superior DFS in the discovery cohort (adjusted hazard ratio [HR], 0.54; 95% confidence interval [CI] 0.33–0.86; P = 0.010) and validation cohort (adjusted HR, 0.57; 95% CI 0.36–0.92; P = 0.022). The I-score improved the prognostic stratification when integrating it into the Cox proportional hazard regression models with other risk factors (discovery cohort, C-index 0.742 vs. 0.728; validation cohort, C-index 0.695 vs. 0.685). Conclusion This automated workflow and immune scoring system would advance the clinical application of immune microenvironment evaluation and support the clinical decision making for patients with resected NSCLC. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03458-9.
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Wang G, Qiu M, Xing X, Zhou J, Yao H, Li M, Yin R, Hou Y, Li Y, Pan S, Huang Y, Yang F, Bai F, Nie H, Di S, Guo L, Meng Z, Wang J, Yin Y. Lung cancer scRNA-seq and lipidomics reveal aberrant lipid metabolism for early-stage diagnosis. Sci Transl Med 2022; 14:eabk2756. [PMID: 35108060 DOI: 10.1126/scitranslmed.abk2756] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Lung cancer is the leading cause of cancer mortality, and early detection is key to improving survival. However, there are no reliable blood-based tests currently available for early-stage lung cancer diagnosis. Here, we performed single-cell RNA sequencing of different early-stage lung cancers and found that lipid metabolism was broadly dysregulated in different cell types, with glycerophospholipid metabolism as the most altered lipid metabolism-related pathway. Untargeted lipidomics was carried out in an exploratory cohort of 311 participants. Through support vector machine algorithm-based and mass spectrum-based feature selection, we identified nine lipids (lysophosphatidylcholines 16:0, 18:0, and 20:4; phosphatidylcholines 16:0-18:1, 16:0-18:2, 18:0-18:1, 18:0-18:2, and 16:0-22:6; and triglycerides 16:0-18:1-18:1) as the features most important for early-stage cancer detection. Using these nine features, we developed a liquid chromatography-mass spectrometry (MS)-based targeted assay using multiple reaction monitoring. This target assay achieved 100.00% specificity on an independent validation cohort. In a hospital-based lung cancer screening cohort of 1036 participants examined by low-dose computed tomography and a prospective clinical cohort containing 109 participants, the assay reached more than 90.00% sensitivity and 92.00% specificity. Accordingly, matrix-assisted laser desorption/ionization MS imaging confirmed that the selected lipids were differentially expressed in early-stage lung cancer tissues in situ. This method, designated as Lung Cancer Artificial Intelligence Detector, may be useful for early detection of lung cancer or large-scale screening of high-risk populations for cancer prevention.
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Affiliation(s)
- Guangxi Wang
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Mantang Qiu
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Xudong Xing
- Biomedical Pioneering Innovation Center (BIOPIC), School of Life Sciences, Peking University, Beijing 100871, China
| | - Juntuo Zhou
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Hantao Yao
- Institute of Automation, Chinese Academy of Sciences (CAS), Beijing 100190, China
| | - Mingru Li
- Department of Thoracic Surgery, Aerospace 731 Hospital, Beijing 100074, China
| | - Rong Yin
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - Yan Hou
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yang Li
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Shuli Pan
- Medical Examination Center, Aerospace 731 Hospital, Beijing 100074, China
| | - Yuqing Huang
- Department of Thoracic Surgery, Beijing Haidian Hospital, Beijing 100080, China
| | - Fan Yang
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Fan Bai
- Biomedical Pioneering Innovation Center (BIOPIC), School of Life Sciences, Peking University, Beijing 100871, China
| | - Honggang Nie
- Analytical Instrumentation Center, Peking University, Beijing 100871, China
| | - Shuangshuang Di
- Analytical Instrumentation Center, Peking University, Beijing 100871, China
| | - Limei Guo
- Department of Pathology, Peking University Third Hospital, Beijing 100191, China
| | - Zhu Meng
- Beijing University of Posts and Telecommunications, Beijing Key Laboratory of Network System and Network Culture, Beijing 100876, China
| | - Jun Wang
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
| | - Yuxin Yin
- Institute of Systems Biomedicine, Department of Pathology, School of Basic Medical Sciences, Peking-Tsinghua Center for Life Sciences, Peking University Health Science Center and Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100191, China
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Zhang MY, Huo C, Liu JY, Shi ZE, Zhang WD, Qu JJ, Yue YL, Qu YQ. Identification of a Five Autophagy Subtype-Related Gene Expression Pattern for Improving the Prognosis of Lung Adenocarcinoma. Front Cell Dev Biol 2021; 9:756911. [PMID: 34869345 PMCID: PMC8636677 DOI: 10.3389/fcell.2021.756911] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Autophagy plays an important role in lung adenocarcinoma (LUAD). In this study, we aimed to explore the autophagy-related gene (ARG) expression pattern and to identify promising autophagy-related biomarkers to improve the prognosis of LUAD. Methods: The gene expression profiles and clinical information of LUAD patients were downloaded from the Cancer Genome Atlas (TCGA), and validation cohort information was extracted from the Gene Expression Omnibus database. The Human Autophagy Database (HADb) was used to extract ARGs. Gene expression data were analyzed using the limma package and visualized using the ggplot2 package as well as the pheatmap package in R software. Functional enrichment analysis was also performed for the differentially expressed ARGs (DEARGs). Then, consensus clustering revealed autophagy-related tumor subtypes, and differentially expressed genes (DEGs) were screened according to the subtypes. Next, the univariate Cox and multivariate Cox regression analyses were used to identify independent prognostic ARGs. After overlapping DEGs and the independent prognostic ARGs, the predictive risk model was established and validated. Correlation analyses between ARGs and clinicopathological variables were also explored. Finally, the TIMER and TISIDB databases were used to further explore the correlation analysis between immune cell infiltration levels and the risk score as well as clinicopathological variables in the predictive risk model. Results: A total of 222 genes from the HADb were identified as ARGs, and 28 of the 222 genes were pooled as DEARGs. The most significant GO term was autophagy (p = 3.05E-07), and KEGG analysis results indicated that 28 DEARGs were significantly enriched in the ErbB signaling pathway (p < 0.001). Then, consensus clustering analysis divided the LUAD into two clusters, and a total of 168 DEGs were identified according to cluster subtypes. Then univariate and multivariate Cox regression analyses were used to identify 12 genes that could serve as independent prognostic indicators. After overlapping 168 DEGs and 12 genes, 10 genes (ATG4A, BAK1, CAPNS1, CCR2, CTSD, EIF2AK3, ITGB1, MBTPS2, SPHK1, ST13) were selected for the further exploration of the prognostic pattern. Survival analysis results indicated that this risk model identified the prognosis (p = 4.379E-10). Combined with the correlation analysis results between ARGs and clinicopathological variables, five ARGs were screened as prognostic genes. Among them, SPHK1 expression levels were positively correlated with CD4+ T cells and dendritic cell infiltration levels. Conclusions: In this study, we constructed a predictive risk model and identified a five autophagy subtype-related gene expression pattern to improve the prognosis of LUAD. Understanding the subtypes of LUAD is helpful to accurately characterize the LUAD and develop personalized treatment.
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Affiliation(s)
- Meng-Yu Zhang
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Chen Huo
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Jian-Yu Liu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Zhuang-E Shi
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Wen-Di Zhang
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Jia-Jia Qu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Yue-Liang Yue
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
| | - Yi-Qing Qu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University; Shandong Key Laboratory of Infectious Respiratory Diseases, Jinan, China
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10
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Newport EL, Pedrosa AR, Njegic A, Hodivala-Dilke KM, Muñoz-Félix JM. Improved Immunotherapy Efficacy by Vascular Modulation. Cancers (Basel) 2021; 13:5207. [PMID: 34680355 PMCID: PMC8533721 DOI: 10.3390/cancers13205207] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022] Open
Abstract
Several strategies have been developed to modulate the tumour vasculature for cancer therapy including anti-angiogenesis and vascular normalisation. Vasculature modulation results in changes to the tumour microenvironment including oxygenation and immune cell infiltration, therefore lending itself to combination with cancer therapy. The development of immunotherapies has led to significant improvements in cancer treatment. Particularly promising are immune checkpoint blockade and CAR T cell therapies, which use antibodies against negative regulators of T cell activation and T cells reprogrammed to better target tumour antigens, respectively. However, while immunotherapy is successful in some patients, including those with advanced or metastatic cancers, only a subset of patients respond. Therefore, better predictors of patient response and methods to overcome resistance warrant investigation. Poor, or periphery-limited, T cell infiltration in the tumour is associated with poor responses to immunotherapy. Given that (1) lymphocyte recruitment requires leucocyte-endothelial cell adhesion and (2) the vasculature controls tumour oxygenation and plays a pivotal role in T cell infiltration and activation, vessel targeting strategies including anti-angiogenesis and vascular normalisation in combination with immunotherapy are providing possible new strategies to enhance therapy. Here, we review the progress of vessel modulation in enhancing immunotherapy efficacy.
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Affiliation(s)
- Emma L. Newport
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; (E.L.N.); (A.R.P.); (A.N.); (K.M.H.-D.)
| | - Ana Rita Pedrosa
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; (E.L.N.); (A.R.P.); (A.N.); (K.M.H.-D.)
| | - Alexandra Njegic
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; (E.L.N.); (A.R.P.); (A.N.); (K.M.H.-D.)
| | - Kairbaan M. Hodivala-Dilke
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; (E.L.N.); (A.R.P.); (A.N.); (K.M.H.-D.)
| | - José M. Muñoz-Félix
- Centre for Tumour Microenvironment, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; (E.L.N.); (A.R.P.); (A.N.); (K.M.H.-D.)
- Department of Biochemistry and Molecular Biology, Institute of Biomedical Research of Salamanca (IBSAL), Universidad de Salamanca Spain, 37007 Salamanca, Spain
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11
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Havnar C, Lau S, Hung J, Eastham-Anderson J, Espiritu C, Rangell L, Koeppen H, Ziai J, Foreman O. Characterization of Tumor-immune Microenvironment by High-throughput Image Analysis of CD8 Immunohistochemistry Combined With Modified Masson's Trichrome. J Histochem Cytochem 2021; 69:611-615. [PMID: 34353148 DOI: 10.1369/00221554211034935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
With the advent of checkpoint inhibitors, there is increasing need to study the dynamics of CD8+ T-cells in the tumor microenviroment. In this article, we describe a semi-automated method to quantify and interrogate spatial relationships between T-cells and collagenous stroma in human and mouse tissue samples. The assay combines CD8 immunohistochemistry with modified Masson's trichrome. Slides are scanned and digital images are analyzed using an adjustable MATLAB algorithm, allowing for high-throughput quantification of cytotoxic T-cells and collagen. This method provides a flexible tool for unbiased quantification of T-cells and their interactions with tumor cells and tumor microenvironment in tissue samples.
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Affiliation(s)
- Charles Havnar
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - Shari Lau
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - Jeffrey Hung
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | | | - Carmina Espiritu
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - Linda Rangell
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - Hartmut Koeppen
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - James Ziai
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
| | - Oded Foreman
- Department of Research Pathology, Genentech, Inc., South San Francisco, California
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12
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Kockx MM, McCleland M, Koeppen H. Microenvironmental regulation of tumour immunity and response to immunotherapy. J Pathol 2021; 254:374-383. [PMID: 33846997 PMCID: PMC8252752 DOI: 10.1002/path.5681] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/25/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
The confluence of immunology and oncology has led to a lot of uncertainty and questions about relevant biomarkers. Despite the complexity of the tumour microenvironment, most clinical studies have relied on a single‐parameter immunohistochemical assay to prospectively select patients for checkpoint inhibitor therapy; the results of this strategy have been highly variable and often less than optimal. While great efforts have been made to identify additional or alternative biomarkers, pathologists, drug developers, and clinicians alike have faced technical, logistical, and regulatory challenges on how to implement them successfully. In this review, we will discuss these challenges; we will also highlight recent advances in dissecting the functional diversity of immune cell populations within the tumour microenvironment and their potential for improved, biomarker‐driven therapeutic strategies. The dynamic nature and cellular diversity of the tumour microenvironment may challenge past models of a single biomarker predicting patient response and clinical outcome. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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13
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Xu F, He L, Zhan X, Chen J, Xu H, Huang X, Li Y, Zheng X, Lin L, Chen Y. DNA methylation-based lung adenocarcinoma subtypes can predict prognosis, recurrence, and immunotherapeutic implications. Aging (Albany NY) 2020; 12:25275-25293. [PMID: 33234739 PMCID: PMC7803536 DOI: 10.18632/aging.104129] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
The marked heterogeneity of lung adenocarcinoma (LUAD) makes its diagnosis and treatment difficult. In addition, the aberrant DNA methylation profile contributes to tumor heterogeneity and alters the immune response. We used DNA methylation array data from publicly available databases to establish a predictive model for LUAD prognosis. Thirty-three methylation sites were identified as specific prognostic biomarkers, independent of patients' clinical characteristics. These methylation profiles were used to identify potential drug candidates and study the immune microenvironment of LUAD and response to immunotherapy. When compared with the high-risk group, the low-risk group had a lower recurrence rate and favorable prognosis. The tumor microenvironment differed between the two groups as reflected by the higher number of resting dendritic cells and a lower number of monocytes and resting mast cells in the low-risk group. Moreover, low-risk patients reported higher immune and stromal scores, lower tumor purity, and higher expression of HLA genes. Low-risk patients responded well to immunotherapy due to higher expression of immune checkpoint molecules and lower stemness index. Thus, our model predicted a favorable prognosis and increased overall survival for patients in the low-risk methylation group. Further, this model could provide potential drug targets to develop effective immunotherapies for LUAD.
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Affiliation(s)
- Feng Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Lulu He
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xueqin Zhan
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiexin Chen
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Huan Xu
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiaoling Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yangyi Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiaohe Zheng
- Department of Respiratory Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Ling Lin
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yongsong Chen
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
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14
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Chen B, Li H, Liu C, Xiang X, Wang S, Wu A, Shen Y, Li G. Prognostic value of the common tumour-infiltrating lymphocyte subtypes for patients with non-small cell lung cancer: A meta-analysis. PLoS One 2020; 15:e0242173. [PMID: 33170901 PMCID: PMC7654825 DOI: 10.1371/journal.pone.0242173] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/27/2020] [Indexed: 12/25/2022] Open
Abstract
Background Many previous studies have revealed that tumour-infiltrating lymphocytes (TILs) are significantly associated with prognosis in various tumours. However, this finding remains controversial in non-small cell lung cancer (NSCLC). We performed this meta-analysis systematically to evaluate the prognostic value of TILs in NSCLC. Methods The references were collected by searching the PubMed, EMBASE and Web of Science databases. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were summarized using random or fixed effects models to evaluate the association between TILs and NSCLC survival outcomes. Results A total of 45 interrelated studies were eligible that included 11,448 patients. Pooled analysis showed that a high density of TILs indicated a better overall survival (HR = 0.80, 0.70–0.89) and progression-free survival (HR = 0.73, 0.61–0.85) for patients with NSCLC; a high density of CD3+ TILs in the tumour nest indicated a better overall survival (HR = 0.84, 0.69–0.99) and disease-specific survival (HR = 0.57, 0.34–0.80); a high density of CD4+ TILs in the tumor nest indicated a favourable overall survival (HR = 0.86, 0.76–0.96); a high density of CD8+ TILs indicated a favourable overall survival (HR = 0.995, 0.99–1.0), progression-free survival (HR = 0.52, 0.34–0.71), disease-free survival (HR = 0.64, 0.43–0.85), relapse/recurrence-free survival (HR = 0.42, 0.18–0.67) and disease-specific survival (HR = 0.56, 0.35–0.78); and a high density of CD20+ TILs in the tumour nest indicated a favourable overall survival (HR = 0.65, 0.36–0.94). However, a high density of Foxp3+ TILs in the tumour stroma indicated a worse relapse/recurrence-free survival (HR = 1.90, 1.05–2.76) in NSCLC. Conclusions Our meta-analysis confirmed that high densities of TILs, CD3+TILs, CD4+TILs, CD8+TILs and CD20+TILs in the tumour nest are favourable prognostic biomarkers for patients with NSCLC, and Foxp3+TILs in the tumour stroma are a poor prognostic biomarker.
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Affiliation(s)
- Benchao Chen
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Heng Li
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Chao Liu
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Xudong Xiang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Shuting Wang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Anhao Wu
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Yan Shen
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Gaofeng Li
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
- * E-mail:
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15
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Yang ZR, Liu MN, Yu JH, Yang YH, Chen TX, Han YC, Zhu L, Zhao JK, Fu XL, Cai XW. Treatment of stage III non-small cell lung cancer in the era of immunotherapy: pathological complete response to neoadjuvant pembrolizumab and chemotherapy. Transl Lung Cancer Res 2020; 9:2059-2073. [PMID: 33209626 PMCID: PMC7653116 DOI: 10.21037/tlcr-20-896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Non-small cell lung cancer (NSCLC) accounts for about 85% of all lung cancers. The expected 5-year survival of stage III NSCLC ranges from 13% to 36% for stage III. Due to the heterogeneity and poor efficacy of stage III patients, there is great controversy on how to optimize the therapy strategy. Immunotherapy is providing better clinical efficacy to more NSCLC patients, and is rapidly extending its range of care from advanced stage to locally advanced stage and early stage NSCLC. Due to the patient’s strong treatment intention, drug availability, and a few encouraging results from clinical trials (NADIM, NCT02716038, etc.), the authors observed a case of stage III NSCLC that achieved complete remission after receiving neoadjuvant chemotherapy combined with immunotherapy. In view of such a satisfactory result in neoadjuvant therapy, this article discusses how comprehensive treatment for stage III NSCLC patients may be conducted and the manner in which various therapeutic techniques can be mastered in the era of immunotherapy. Immunotherapy has opened the exploratory space for finding resolutions to numerous challenges of treating stage III NSCLC. Further clinical studies and exploration of personalized treatment, guided by imaging data, and clinical and pathological biomarkers are imperative for the benefit of these patients.
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Affiliation(s)
- Zhang-Ru Yang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mi-Na Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Hua Yu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yun-Hai Yang
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tian-Xiang Chen
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Chen Han
- Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhu
- Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ji-Kai Zhao
- Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Long Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu-Wei Cai
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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16
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Garzon-Muvdi T, Bailey DD, Pernik MN, Pan E. Basis for Immunotherapy for Treatment of Meningiomas. Front Neurol 2020; 11:945. [PMID: 32982948 PMCID: PMC7483661 DOI: 10.3389/fneur.2020.00945] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022] Open
Abstract
Meningiomas are common tumors that account for approximately one third of CNS tumors diagnosed every year. They are classified by the World Health Organization in grades I-III. Higher grades have an increased rate of growth, invasiveness, rate of recurrence, and worse outcomes than lower grades. Most meningiomas are grade I, while ~18% of meningiomas are grade II and III in hospital-based series. Meningiomas are typically "benign" tumors that are treated with surgery and radiation. However, when they recur or are unresectable, treatment options are very limited, especially since they are chemotherapy-resistant. Recent advances in the treatment of cancers with immunotherapy have focused on checkpoint blockade as well as other types of immunotherapy. There is emerging evidence supporting the use of immunotherapy as a potentially effective treatment strategy for meningioma patients. The immune microenvironment of meningiomas is a complex interplay of genetic alterations, immunomodulatory protein expression, and tumor-immune cell interactions. Meningiomas are known to be infiltrated by immune cells including microglia, macrophages, B-cells, and T-cells. Several mechanisms contribute to decreased an ti-tumor immune response, allowing tumor growth and evasion of the immune system. We discuss the most current knowledge on the immune micro-environment of meningiomas, preclinical findings of immunotherapy in meningiomas, meningioma immunotherapy clinical trials, and also offer insight into future prospects for immunotherapies in meningiomas.
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Affiliation(s)
- Tomas Garzon-Muvdi
- Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - Destiny D. Bailey
- Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - Mark N. Pernik
- Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - Edward Pan
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, United States
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17
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Xu F, Chen JX, Yang XB, Hong XB, Li ZX, Lin L, Chen YS. Analysis of Lung Adenocarcinoma Subtypes Based on Immune Signatures Identifies Clinical Implications for Cancer Therapy. Mol Ther Oncolytics 2020; 17:241-249. [PMID: 32346613 PMCID: PMC7183104 DOI: 10.1016/j.omto.2020.03.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 03/26/2020] [Indexed: 02/05/2023] Open
Abstract
Lung cancer is the most common cause of cancer deaths worldwide, and lung adenocarcinoma (LUAD) is the most common histological subtype. However, the prognostic and predictive outcomes differ because of this cancer type heterogeneity. LUAD subtypes were identified on the basis of the immunogenomic profiling of 29 immune signatures. We named three LUAD subtypes: Immunity High, Immunity Medium, and Immunity Low. The Immunity High subtype was characterized by immune activation, e.g., increased immune scores, elevated stromal scores and the highest infiltration of CD8+ T cells, and decreased tumor purities. Activated expressions of human leukocyte antigen (HLA) genes, immune checkpoint molecules, and T helper 1 (Th1)/interferon-gamma (IFNγ) gene signature were also observed in the Immunity High subtype. N 6-methyladenosine (m6A) RNA methylation, associated with cancer initiation and progression, was reduced in the Immunity High subtype. Functional and signaling pathway enrichment analysis further showed that differentially expressed genes between the Immunity High subtype and the other subtypes mainly participated in immune response and some cancer-associated pathways. In addition, the Immunity High subtype exhibited more sensitivity to immunotherapy and chemotherapy. Finally, candidate compounds that aimed at LUAD subtype differentiation were identified. Comprehensively characterizing the LUAD subtypes based on immune signatures may help to provide potential strategies for LUAD treatment.
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Affiliation(s)
- Feng Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
| | - Jie-xin Chen
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
| | - Xiong-bin Yang
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
| | - Xin-bin Hong
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
| | - Zi-xiong Li
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
| | - Ling Lin
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
- Corresponding author Ling Lin, Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China.
| | - Yong-song Chen
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China
- Corresponding author Yong-song Chen, Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong 515041, P.R. China.
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18
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Frafjord A, Skarshaug R, Hammarström C, Stankovic B, Dorg LT, Aamodt H, Woldbaek PR, Helland Å, Brustugun OT, Øynebråten I, Corthay A. Antibody combinations for optimized staining of macrophages in human lung tumours. Scand J Immunol 2020; 92:e12889. [PMID: 32299134 DOI: 10.1111/sji.12889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 12/13/2022]
Abstract
The analysis of tumour-associated macrophages (TAMs) has a high potential to predict cancer recurrence and response to immunotherapy. However, the heterogeneity of TAMs poses a challenge for quantitative and qualitative measurements. Here, we critically evaluated by immunohistochemistry and flow cytometry two commonly used pan-macrophage markers (CD14 and CD68) as well as some suggested markers for tumour-promoting M2 macrophages (CD163, CD204, CD206 and CD209) in human non-small cell lung cancer (NSCLC). Tumour, non-cancerous lung tissue and blood were investigated. For immunohistochemistry, CD68 was confirmed to be a useful pan-macrophage marker although careful selection of antibody was found to be critical. The widely used anti-CD68 antibody clone KP-1 stains both macrophages and neutrophils, which is problematic for TAM quantification because lung tumours contain many neutrophils. For TAM counting in tumour sections, we recommend combined labelling of CD68 with a cell membrane marker such as CD14, CD163 or CD206. In flow cytometry, the commonly used combination of CD14 and HLA-DR was found to not be optimal because some TAMs do not express CD14. Instead, combined staining of CD68 and HLA-DR is preferable to gate all TAMs. Concerning macrophage phenotypic markers, the scavenger receptor CD163 was found to be expressed by a substantial fraction (50%-86%) of TAMs with a large patient-to-patient variation. Approximately 50% of TAMs were positive for CD206. Surprisingly, there was no clear overlap between CD163 and CD206 positivity, and three distinct TAM sub-populations were identified in NSCLC tumours: CD163+ CD206+ , CD163+ CD206- and CD163- CD206- . This work should help develop macrophage-based prognostic tools for cancer.
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Affiliation(s)
- Astri Frafjord
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Renate Skarshaug
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Clara Hammarström
- Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Branislava Stankovic
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Linda T Dorg
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.,Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Henrik Aamodt
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.,Department of Cardiothoracic Surgery, Ullevål Hospital, Oslo University Hospital, Oslo, Norway
| | - Per Reidar Woldbaek
- Department of Cardiothoracic Surgery, Ullevål Hospital, Oslo University Hospital, Oslo, Norway
| | - Åslaug Helland
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Odd Terje Brustugun
- Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Section of Oncology, Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway
| | - Inger Øynebråten
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Alexandre Corthay
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.,Hybrid Technology Hub - Centre of Excellence, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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19
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Tao X, Wu X, Huang T, Mu D. Identification and Analysis of Dysfunctional Genes and Pathways in CD8 + T Cells of Non-Small Cell Lung Cancer Based on RNA Sequencing. Front Genet 2020; 11:352. [PMID: 32457792 PMCID: PMC7227791 DOI: 10.3389/fgene.2020.00352] [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: 01/02/2020] [Accepted: 03/23/2020] [Indexed: 12/26/2022] Open
Abstract
Lung cancer, the most common of malignant tumors, is typically of the non-small cell (NSCLC) type. T-cell-based immunotherapies are a promising and powerful approach to treating NSCLCs. To characterize the CD8+ T cells of non-small cell lung cancer, we re-analyzed the published RNA-Seq gene expression profiles of 36 CD8+ T cell isolated from tumor (TIL) samples and 32 adjacent uninvolved lung (NTIL) samples. With an advanced Monte Carlo method of feature selection, we identified the CD8+ TIL specific expression patterns. These patterns revealed the key dysfunctional genes and pathways in CD8+ TIL and shed light on the molecular mechanisms of immunity and use of immunotherapy.
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Affiliation(s)
- Xuefang Tao
- Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Xiaotang Wu
- Shanghai Engineering Research Center of Pharmaceutical Translation, Shanghai, China
| | - Tao Huang
- Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Deguang Mu
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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20
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Qu Y, Cheng B, Shao N, Jia Y, Song Q, Tan B, Wang J. Prognostic value of immune-related genes in the tumor microenvironment of lung adenocarcinoma and lung squamous cell carcinoma. Aging (Albany NY) 2020; 12:4757-4777. [PMID: 32209727 PMCID: PMC7138544 DOI: 10.18632/aging.102871] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/20/2020] [Indexed: 01/04/2023]
Abstract
Non-small cell lung cancer (NSCLC), which consists mainly of lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), are the leading cause of cancer deaths worldwide. In this study, we performed a comprehensive analysis of the tumor microenvironmental and genetic factors to identify prognostic biomarkers for NSCLC. We evaluated the immune and stromal scores of patients with LUAD and LUSC using data from The Cancer Genome Atlas database with the ESTIMATE algorithm. Based on these scores, the differentially expressed genes were obtained and immune-related prognostic genes were identified. Functional analysis and protein-protein interaction network further revealed the immune-related biological processes in which these genes participated. Additionally, 22 subsets of tumor-infiltrating immune cells (TIICs) in the tumor microenvironment were analyzed with the CIBERSORT algorithm. Finally, we validated these valuable genes using an independent cohort from the Gene Expression Omnibus database. The associations of the immune and stromal scores with patients’ clinical characteristics and prognosis were positive in LUAD but negative in LUSC and the correlations of TIICs with clinical characteristics were clarified. Several differentially expressed genes were identified to be potential immune-related prognostic genes. This study comprehensively analyzed the tumor microenvironment and presented immune-related prognostic biomarkers for NSCLC.
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Affiliation(s)
- Yan Qu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Bo Cheng
- Department of Radiation Oncology, Shandong Provincial Cancer Hospital, Jinan 250117, Shandong, China
| | - Na Shao
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
| | - Yibin Jia
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Qingxu Song
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Bingxu Tan
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Jianbo Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
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A 5-Gene Signature Is Closely Related to Tumor Immune Microenvironment and Predicts the Prognosis of Patients with Non-Small Cell Lung Cancer. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2147397. [PMID: 31998783 PMCID: PMC6975218 DOI: 10.1155/2020/2147397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/22/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
Purpose Establishing prognostic gene signature to predict clinical outcomes and guide individualized adjuvant therapy is necessary. Here, we aim to establish the prognostic efficacy of a gene signature that is closely related to tumor immune microenvironment (TIME). Methods and Results There are 13,035 gene expression profiles from 130 tumor samples of the non-small cell lung cancer (NSCLC) in the data set GSE103584. A 5-gene signature was identified by using univariate survival analysis and Least Absolute Shrinkage and Selection Operator (LASSO) to build risk models. Then, we used the CIBERSORT method to quantify the relative levels of different immune cell types in complex gene expression mixtures. It was found that the ratio of dendritic cells (DCs) activated and mast cells (MCs) resting in the low-risk group was higher than that in the high-risk group, and the difference was statistically significant (P < 0.001 and P=0.03). Pathway enrichment results which were obtained by performing Gene Set Variation Analysis (GSVA) showed that the high-risk group identified by the 5-gene signature had metastatic-related gene expression, resulting in lower survival rates. Kaplan–Meier survival results showed that patients of the high-risk group had shorter disease-free survival (DFS) and overall survival (OS) than those of the low-risk group in the training set (P=0.0012 and P < 0.001). The sensitivity and specificity of the gene signature were better and more sensitive to prognosis than TNM (tumor/lymph node/metastasis) staging, in spite of being not statistically significant (P=0.154). Furthermore, Kaplan–Meier survival showed that patients of the high-risk group had shorter OS and PFS than those of the low-risk group (P=0.0035, P < 0.001, and P < 0.001) in the validating set (GSE31210, GSE41271, and TCGA). At last, univariate and multivariate Cox proportional hazard regression analyses were used to evaluate independent prognostic factors associated with survival, and the gene signature, lymphovascular invasion, pleural invasion, chemotherapy, and radiation were employed as covariates. The 5-gene signature was identified as an independent predictor of patient survival in the presence of clinical parameters in univariate and multivariate analyses (P < 0.001) (hazard ratio (HR): 3.93, 95% confidence interval CI (2.17–7.1), P=0.001, (HR) 5.18, 95% CI (2.6995–9.945), P < 0.001), respectively. Our 5-gene signature was also related to EGFR mutations (P=0.0111), and EGFR mutations were mainly enriched in low-risk group, indicating that EGFR mutations affect the survival rate of patients. Conclusion The 5-gene signature is a powerful and independent predictor that could predict the prognosis of NSCLC patients. In addition, our gene signature is correlated with TIME parameters, such as DCs activated and MCs resting. Our findings suggest that the 5-gene signature closely related to TIME could predict the prognosis of NSCLC patients and provide some reference for immunotherapy.
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22
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Sharma S, Kadam P, Dubinett S. CCL21 Programs Immune Activity in Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1231:67-78. [PMID: 32060847 DOI: 10.1007/978-3-030-36667-4_7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CCL21 promotes immune activity in the tumor microenvironment (TME) by colocalizing dendritic cells (DC) and T cells programing ectopic lymph node architectural structures that correlate with cancer prognosis. Innovative strategies to deliver CCL21 in cancer patients will reactivate the downregulated immune activity in the TME. Immune escape mechanisms are upregulated in the TME that promote tumor immune evasion. CCL21 combined with inhibition of dominant pathways of immune evasion will aid in the development of effective immunotherapy for cancer.
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Affiliation(s)
- Sherven Sharma
- Department of Medicine, UCLA Lung Cancer Research Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. .,Molecular Gene Medicine Laboratory, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA. .,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Pournima Kadam
- Molecular Gene Medicine Laboratory, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Steven Dubinett
- Department of Medicine, UCLA Lung Cancer Research Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Molecular Gene Medicine Laboratory, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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23
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Cao L, Che X, Qiu X, Li Z, Yang B, Wang S, Hou K, Fan Y, Qu X, Liu Y. M2 macrophage infiltration into tumor islets leads to poor prognosis in non-small-cell lung cancer. Cancer Manag Res 2019; 11:6125-6138. [PMID: 31308749 PMCID: PMC6613613 DOI: 10.2147/cmar.s199832] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/10/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Lung cancer is the leading cause of cancer-related death worldwide. Although the macrophages can affect the development of tumor, the contribution of macrophages to the prognosis of non-small-cell lung cancer (NSCLC) is still controversial. Moreover, anti-PD-1 therapy can redirect macrophages from an M2 to an M1 phenotype, suggesting that tumor PD-L1 may affect the prognostic role of macrophages. Therefore, in this study, we aimed to display a macrophage landscape to clarify the function of macrophages, considering the localization and polarization of the macrophages, and evaluate the effect of M2 macrophages and tumor PD-L1 in combination on the prognosis of NSCLC. Methods: We performed multiplex quantitative immunofluorescence staining of pan-cytokeratin (CK), CD68, CD163, PD-L1, and DAPI on one tissue specimen simultaneously from 137 NSCLC patients. Results: M2 macrophages, involved marginM2 (M2 macrophages in tumor stroma), and centralM2 (M2 macrophages infiltrating into tumor islets) increased as the tumor stage increased. More macrophages were found in lung squamous cell carcinoma (LUSC) patients, patients with wild-type EGFR, and smokers than in patients with lung adenocarcinoma (LUAD), patients with EGFR mutations, and non-smokers. Infiltration of centralM2 was an independent prognostic factor of poor overall survival (OS) and disease-free survival (DFS) for NSCLC patients (P<0.05), which was superior to total macrophages and total M2 macrophages. Moreover, patients with centralM2lessPD-L1- tumors showed the best OS and DFS, while the patients with centralM2morePD-L1+ tumors showed the worst OS and DFS, and the two groups with centralM2lessPD-L1+ and centralM2morePD-L1- were in the middle (P=0.002, 0.034, respectively). Conclusion: Tumor islet-infiltrating M2 macrophages influence the prognosis of NSCLC patients. The analysis of M2 macrophages and tumor PD-L1 in combination may enhance the accuracy of prognostic prediction. This study provides a new understanding of macrophages in the development of NSCLC through the analysis of macrophage landscape.
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Affiliation(s)
- Lili Cao
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Xiaofang Che
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Xueshan Qiu
- Department of Pathology, College of Basic Medical Sciences of China Medical University, Shenyang 110001, People's Republic of China
| | - Zhi Li
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Bowen Yang
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Shuo Wang
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Kezuo Hou
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Yibo Fan
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Xiujuan Qu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
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24
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Stankovic B, Bjørhovde HAK, Skarshaug R, Aamodt H, Frafjord A, Müller E, Hammarström C, Beraki K, Bækkevold ES, Woldbæk PR, Helland Å, Brustugun OT, Øynebråten I, Corthay A. Immune Cell Composition in Human Non-small Cell Lung Cancer. Front Immunol 2019; 9:3101. [PMID: 30774636 PMCID: PMC6367276 DOI: 10.3389/fimmu.2018.03101] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 12/14/2018] [Indexed: 12/11/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the world. Immunological analysis of the tumor microenvironment (immunoscore) shows great promise for improved prognosis and prediction of response to immunotherapy. However, the exact immune cell composition in NSCLC remains unclear. Here, we used flow cytometry to characterize the immune infiltrate in NSCLC tumors, non-cancerous lung tissue, regional lymph node, and blood. The cellular identity of >95% of all CD45+ immune cells was determined. Thirteen distinct immune cell types were identified in NSCLC tumors. T cells dominated the lung cancer landscape (on average 47% of all CD45+ immune cells). CD4+ T cells were the most abundant T cell population (26%), closely followed by CD8+ T cells (22%). Double negative CD4−CD8− T cells represented a small fraction (1.4%). CD19+ B cells were the second most common immune cell type in NSCLC tumors (16%), and four different B cell sub-populations were identified. Macrophages and natural killer (NK) cells composed 4.7 and 4.5% of the immune cell infiltrate, respectively. Three types of dendritic cells (DCs) were identified (plasmacytoid DCs, CD1c+ DCs, and CD141+ DCs) which together represented 2.1% of all immune cells. Among granulocytes, neutrophils were frequent (8.6%) with a high patient-to-patient variability, while mast cells (1.4%), basophils (0.4%), and eosinophils (0.3%) were less common. Across the cohort of patients, only B cells showed a significantly higher representation in NSCLC tumors compared to the distal lung. In contrast, the percentages of macrophages and NK cells were lower in tumors than in non-cancerous lung tissue. Furthermore, the fraction of macrophages with high HLA-DR expression levels was higher in NSCLC tumors relative to distal lung tissue. To make the method readily accessible, antibody panels and flow cytometry gating strategy used to identify the various immune cells are described in detail. This work should represent a useful resource for the immunomonitoring of patients with NSCLC.
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Affiliation(s)
- Branislava Stankovic
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Heidi Anine Korsmo Bjørhovde
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Renate Skarshaug
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Henrik Aamodt
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.,Department of Cardiothoracic Surgery, Ullevål Hospital, Oslo University Hospital, Oslo, Norway
| | - Astri Frafjord
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Elisabeth Müller
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Clara Hammarström
- Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Kahsai Beraki
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Espen S Bækkevold
- Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Per Reidar Woldbæk
- Department of Cardiothoracic Surgery, Ullevål Hospital, Oslo University Hospital, Oslo, Norway
| | - Åslaug Helland
- Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Department of Genetics, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Odd Terje Brustugun
- Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Inger Øynebråten
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Alexandre Corthay
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
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25
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Gérard C, Hubeau C, Carnet O, Bellefroid M, Sounni NE, Blacher S, Bendavid G, Moser M, Fässler R, Noel A, Cataldo D, Rocks N. Microenvironment-derived ADAM28 prevents cancer dissemination. Oncotarget 2018; 9:37185-37199. [PMID: 30647853 PMCID: PMC6324684 DOI: 10.18632/oncotarget.26449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/26/2018] [Indexed: 01/25/2023] Open
Abstract
Previous studies have linked cancer cell-associated ADAM28 expression with tumor progression and metastatic dissemination. However, the role of host-derived ADAM28 in cancer dissemination processes remains unclear. Genetically engineered-mice fully deficient for ADAM28 unexpectedly display increased lung colonization by pulmonary, melanoma or breast tumor cells. In experimental tumor cell dissemination models, host ADAM28 deficiency is further associated with a decreased lung infiltration by CD8+ T lymphocytes. Notably, naive ADAM28-deficient mice already display a drastic reduction of CD8+ T cells in spleen which is further observed in lungs. Interestingly, ex vivo CD8+ T cell characterization revealed that ADAM28-deficiency does not impact proliferation, migration nor activation of CD8+ T cells. Our data highlight a functional role of ADAM28 in T cell mobilization and point to an unexpected protective role for host ADAM28 against metastasis.
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Affiliation(s)
- Catherine Gérard
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Céline Hubeau
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Oriane Carnet
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Marine Bellefroid
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Nor Eddine Sounni
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Silvia Blacher
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Guillaume Bendavid
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium.,ENT Department, University Hospital of Liege, Liege, Belgium
| | - Markus Moser
- Max-Planck-Institute of Biochemistry, Department of Molecular Medicine, Martinsried, Germany
| | - Reinhard Fässler
- Max-Planck-Institute of Biochemistry, Department of Molecular Medicine, Martinsried, Germany
| | - Agnès Noel
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
| | - Didier Cataldo
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium.,Department of Respiratory Diseases, CHU Liege and University of Liege, Liege, Belgium
| | - Natacha Rocks
- Laboratory of Tumor and Development Biology, GIGA-Cancer and GIGA-I3, GIGA-Research, University of Liege, Liege, Belgium
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26
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Lazzari G, Terlizzi A, Porrazzo G, Devicienti S, Perri F, Della Vittoria Scarpati G, Silvano G. Effective nivolumab sequential thoracic radiotherapy in elderly patients with advanced squamous cell lung cancer: did radiation therapy play a role? A case report. Onco Targets Ther 2018; 11:4621-4629. [PMID: 30122953 PMCID: PMC6086101 DOI: 10.2147/ott.s176226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Advanced squamous cell lung carcinoma in elderly patients has a limited chance of cure with first, second line chemotherapy and radiotherapy. Radiotherapy in advanced non-small-cell lung cancer can be used with curative intent for localized or oligometastatic disease using standard or altered fractionations. Current evidence indicates that radiotherapy via diverse cascade mechanisms is able to invoke both local and systemic immunoresponses promoting tumor cell death through an in situ vaccination effect. Moreover, the advancement in immunotherapies is changing the scenario. The combination of radiotherapy and immunotherapy could be a crucial strategy to overcome cancer immunoresistance and improve patient survival, as we found in this case report of an elderly, refractory advanced lung cancer patient who has achieved complete remission after this therapeutic combination.
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Affiliation(s)
- Grazia Lazzari
- Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, Italy,
| | - Angela Terlizzi
- Physics Department, San Giuseppe Moscati Hospital, Taranto, Italy
| | - Giovanna Porrazzo
- Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, Italy,
| | | | - Francesco Perri
- Medical Oncology Department, San Giuseppe Moscati Hospital, Taranto, Italy
| | | | - Giovanni Silvano
- Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, Italy,
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27
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Ferro S, Huber V, Rivoltini L. Mechanisms of tumor immunotherapy, with a focus on thoracic cancers. J Thorac Dis 2018; 10:4619-4631. [PMID: 30174914 DOI: 10.21037/jtd.2018.07.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
If immunotherapy is currently considered as a valid treatment strategy in oncology, the concept that cancer could be cured by the mere manipulation of the immune system was almost inconceivable until few years ago, particularly in lung cancer. The use of immune checkpoint inhibitors has instead demonstrated to mediate significant long-term disease control so to rapidly enter clinical practice and represent the basis for most of the combination approaches under development. In light of the revolutionary results achieved through the pivotal clinical trials and the large expectations about the possibility to further improve clinical benefit and discover novel therapeutic targets, it is becoming nowadays mandatory to increase our knowledge on the basics of immunology in lung cancer. Defining the pathways that rule the interactions between tumor and immune cells and the requirements to achieve full-fledged immune responses able to mediate meaningful antitumor activity are present goals of the research ongoing worldwide. This knowledge would not only foster a more scientifically-based clinical development of novel drugs and combinations, but also provide valid biomarkers for patient selection and monitoring. In the present review we will address the available information about the immunological features of lung cancer, the backgrounds to the use of immunotherapeutics, the possible mechanisms underlying resistance and the strategies to improve immune-mediated tumor control. In doing this, we will be following the path traced in melanoma, the tumor histotype that taught us most of what we know about cancer immunotherapy.
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Affiliation(s)
- Simona Ferro
- Unit of Immunotherapy of Human Tumors, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Veronica Huber
- Unit of Immunotherapy of Human Tumors, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Licia Rivoltini
- Unit of Immunotherapy of Human Tumors, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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28
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Prognostic significance of immune cells in non-small cell lung cancer: meta-analysis. Oncotarget 2018; 9:24801-24820. [PMID: 29872507 PMCID: PMC5973851 DOI: 10.18632/oncotarget.24835] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/06/2018] [Indexed: 12/14/2022] Open
Abstract
Background Tumor-associated immune cells are prognostic in non-small cell lung cancer (NSCLC) but findings have been conflicting. Objectives To determine the prognostic role of immune cells according to localization in NSCLC patients. Methods A systematic literature review and meta-analysis was performed on dendritic cell (DC), tumor associated macrophages (TAM), mast cells (MC), natural killer (NK) cells, T and B cells and tumor CTLA-4 and PD-L1 studies. Results We analysed 96 articles (n= 21,752 patients). Improved outcomes were seen with increased tumor DCs (overall survival (OS) hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.44-0.68), NK cells (OS HR 0.45; 0.31-0.65), TAMs (OS HR 0.33; 0.17-0.62), M1 TAMs (OS HR 0.10; 0.05-0.21), CD3+ T cells (disease specific survival (DSS) HR 0.64; 0.48-0.86), CD8+ T cells (OS HR 0.78; 0.66-0.93), B cells (OS HR 0.65; 0.42-0.99) and with increased stroma DC (DSS HR 0.62; 0.47-0.83), NK cells (DSS HR 0.51; 0.32-0.82), M1 TAMs (OS HR 0.63; 0.42-0.94), CD4+ T cells (OS HR 0.45; 0.21-0.94), CD8+ T cells (OS HR 0.77; 0.69-0.86) and B cells (OS HR 0.74;0.56-0.99). Poor outcomes were seen with stromal M2 TAMs (OS HR 1.44; 1.06-1.96) and Tregs (relapse free survival (RFS) HR 1.80; 1.34-2.43). Tumor PD-L1 was associated with worse OS (1.40; 1.20-1.69), RFS (1.67) and DFS (1.24). Conclusion Tumor and stroma DC, NK cells, M1 TAMs, CD8+ T cells and B cells were associated with improved prognosis and tumor PD-L1, stromal M2 TAMs and Treg cells had poorer prognosis. Higher quality studies are required for confirmation.
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29
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Gobbini E, Giaj Levra M. Is there a room for immune checkpoint inhibitors in early stage non-small cell lung cancer? J Thorac Dis 2018; 10:S1427-S1437. [PMID: 29951294 DOI: 10.21037/jtd.2018.01.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Early non-small cell lung cancer (NSCLC) represents 16% of all new NSCLC at diagnosis with a 5-year survival rate of about 60%. Surgical intervention and adjuvant platinum-based chemotherapy represent the cornerstone treatments, but no significant advances have been achieved since several decades in term of relapse rate reduction or survival improvement. Immunotherapy represents an appealing strategy considering the acceptable toxicity profile but, despite the awesome changing recently introduced in the locally advanced and metastatic setting, its role in early NSCLC is not clear yet. In the past few years, two strategies have been investigated to improve the early NSCLC outcomes eliciting the anti-tumour immune response: tumour vaccines and adoptive cellular therapies. However, none of them provided convincing results. Preclinical and clinical data supported the prognostic role of immune checkpoints in resected NSCLC even if they did not show a clear predictive value for adjuvant treatment. However, some preliminary data about safety and efficacy of neo-adjuvant immune checkpoint inhibitors encourage further investigation of their potential role as monotherapy or as part of a multimodal strategy. Then, even if no significant progress has been done in early NSCLC treatment until today, checkpoint inhibitors can open the door to a new strategy in this setting.
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Affiliation(s)
- Elisa Gobbini
- Department of Oncology, University of Turin, AOU San Luigi Gonzaga, Orbassano, Italy
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30
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Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B, Christie M, van de Vijver K, Estrada MV, Gonzalez-Ericsson PI, Sanders M, Solomon B, Solinas C, Van den Eynden GGGM, Allory Y, Preusser M, Hainfellner J, Pruneri G, Vingiani A, Demaria S, Symmans F, Nuciforo P, Comerma L, Thompson EA, Lakhani S, Kim SR, Schnitt S, Colpaert C, Sotiriou C, Scherer SJ, Ignatiadis M, Badve S, Pierce RH, Viale G, Sirtaine N, Penault-Llorca F, Sugie T, Fineberg S, Paik S, Srinivasan A, Richardson A, Wang Y, Chmielik E, Brock J, Johnson DB, Balko J, Wienert S, Bossuyt V, Michiels S, Ternes N, Burchardi N, Luen SJ, Savas P, Klauschen F, Watson PH, Nelson BH, Criscitiello C, O’Toole S, Larsimont D, de Wind R, Curigliano G, André F, Lacroix-Triki M, van de Vijver M, Rojo F, Floris G, Bedri S, Sparano J, Rimm D, Nielsen T, Kos Z, Hewitt S, Singh B, Farshid G, Loibl S, Allison KH, Tung N, Adams S, Willard-Gallo K, Horlings HM, Gandhi L, Moreira A, Hirsch F, Dieci MV, Urbanowicz M, Brcic I, Korski K, Gaire F, Koeppen H, Lo A, Giltnane J, Ziai J, Rebelatto MC, Steele KE, Zha J, Emancipator K, Juco JW, Denkert C, Reis-Filho J, Loi S, Fox SB. Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors. Adv Anat Pathol 2017; 24:311-335. [PMID: 28777143 PMCID: PMC5638696 DOI: 10.1097/pap.0000000000000161] [Citation(s) in RCA: 453] [Impact Index Per Article: 64.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Assessment of the immune response to tumors is growing in importance as the prognostic implications of this response are increasingly recognized, and as immunotherapies are evaluated and implemented in different tumor types. However, many different approaches can be used to assess and describe the immune response, which limits efforts at implementation as a routine clinical biomarker. In part 1 of this review, we have proposed a standardized methodology to assess tumor-infiltrating lymphocytes (TILs) in solid tumors, based on the International Immuno-Oncology Biomarkers Working Group guidelines for invasive breast carcinoma. In part 2 of this review, we discuss the available evidence for the prognostic and predictive value of TILs in common solid tumors, including carcinomas of the lung, gastrointestinal tract, genitourinary system, gynecologic system, and head and neck, as well as primary brain tumors, mesothelioma and melanoma. The particularities and different emphases in TIL assessment in different tumor types are discussed. The standardized methodology we propose can be adapted to different tumor types and may be used as a standard against which other approaches can be compared. Standardization of TIL assessment will help clinicians, researchers and pathologists to conclusively evaluate the utility of this simple biomarker in the current era of immunotherapy.
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Affiliation(s)
- Shona Hendry
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory/Breast International Group, Institut Jules Bordet, Brussels, Belgium
- Department of Pathology and TCRU, GZA, Antwerp, Belgium
| | - Thomas Gevaert
- Department of Development and Regeneration, Laboratory of Experimental Urology, KU Leuven, Leuven, Belgium
- Department of Pathology, AZ Klina, Brasschaat, Belgium
| | - Prudence A. Russell
- Department of Anatomical Pathology, St Vincent’s Hospital Melbourne, Fitzroy, Australia
- Department of Pathology, University of Melbourne, Parkville, Australia
| | - Tom John
- Department of Medical Oncology, Austin Health, Heidelberg, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- School of Cancer Medicine, La Trobe University, Bundoora, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- Department of Medicine, University of Melbourne, Parkville, Australia
| | - Michael Christie
- Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
| | - Koen van de Vijver
- Divisions of Diagnostic Oncology & Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - M. Valeria Estrada
- Department of Pathology, School of Medicine, University of California, San Diego, USA
| | | | - Melinda Sanders
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - Benjamin Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Cinzia Solinas
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Gert GGM Van den Eynden
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Department of Pathology, GZA Ziekenhuizen, Antwerp, Belgium
| | - Yves Allory
- Université Paris-Est, Créteil, France
- INSERM, UMR 955, Créteil, France
- Département de pathologie, APHP, Hôpital Henri-Mondor, Créteil, France
| | - Matthias Preusser
- Department of Medicine, Clinical Division of Oncology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Johannes Hainfellner
- Institute of Neurology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Giancarlo Pruneri
- European Institute of Oncology, Milan, Italy
- University of Milan, School of Medicine, Milan, Italy
| | - Andrea Vingiani
- European Institute of Oncology, Milan, Italy
- University of Milan, School of Medicine, Milan, Italy
| | - Sandra Demaria
- New York University Medical School, New York, USA
- Perlmutter Cancer Center, New York, USA
| | - Fraser Symmans
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Laura Comerma
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | - Sunil Lakhani
- Centre for Clinical Research and School of Medicine, The University of Queensland, Brisbane, Australia
- Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Seong-Rim Kim
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Stuart Schnitt
- Cancer Research Institute and Department of Pathology, Beth Israel Deaconess Cancer Center, Boston, USA
- Harvard Medical School, Boston, USA
| | - Cecile Colpaert
- Department of Pathology, GZA Ziekenhuizen, Sint-Augustinus, Wilrijk, Belgium
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan J. Scherer
- Academic Medical Innovation, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - Michail Ignatiadis
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sunil Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, USA
| | - Robert H. Pierce
- Cancer Immunotherapy Trials Network, Central Laboratory and Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Nicolas Sirtaine
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Frederique Penault-Llorca
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France
- University of Auvergne UMR1240, Clermont-Ferrand, France
| | - Tomohagu Sugie
- Department of Surgery, Kansai Medical School, Hirakata, Japan
| | - Susan Fineberg
- Montefiore Medical Center, Bronx, New York, USA
- The Albert Einstein College of Medicine, Bronx, New York, USA
| | - Soonmyung Paik
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
- Severance Biomedical Science Institute and Department of Medical Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ashok Srinivasan
- National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, Pennsylvania
| | - Andrea Richardson
- Harvard Medical School, Boston, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, USA
- Department of Cancer Biology, Dana Farber Cancer Institute, Boston, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, USA
- Warren Alpert Medical School of Brown University, Providence, USA
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center, Gliwice, Poland
- Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jane Brock
- Harvard Medical School, Boston, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, USA
| | - Douglas B. Johnson
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA
- Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Justin Balko
- Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA
- Vanderbilt Ingram Cancer Center, Nashville, USA
| | - Stephan Wienert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
- VMscope GmbH, Berlin, Germany
| | - Veerle Bossuyt
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Stefan Michiels
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | - Nils Ternes
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Inserm U1018, Université-Paris Sud, Université Paris-Saclay, Villejuif, France
| | | | - Stephen J. Luen
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Peter Savas
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Peter H. Watson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Brad H. Nelson
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, British Columbia, Canada
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
- Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sandra O’Toole
- The Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, Australia
- Australian Clinical Labs, Bella Vista, Australia
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Roland de Wind
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Fabrice André
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris Sud, Kremlin-Bicêtre, France
| | - Magali Lacroix-Triki
- INSERM Unit U981, and Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Mark van de Vijver
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Federico Rojo
- Pathology Department, IIS-Fundacion Jimenez Diaz, UAM, Madrid, Spain
| | - Giuseppe Floris
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Shahinaz Bedri
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Joseph Sparano
- Department of Oncology, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, USA
| | - David Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Torsten Nielsen
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Zuzana Kos
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Stephen Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baljit Singh
- Department of Pathology, New York University Langone Medical Centre, New York, USA
| | - Gelareh Farshid
- Directorate of Surgical Pathology, SA Pathology, Adelaide, Australia
- Discipline of Medicine, Adelaide University, Adelaide, Australia
| | | | | | - Nadine Tung
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, USA
| | - Sylvia Adams
- New York University Medical School, New York, USA
- Perlmutter Cancer Center, New York, USA
| | - Karen Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Hugo M. Horlings
- Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Leena Gandhi
- Perlmutter Cancer Center, New York, USA
- Dana-Farber Cancer Institute, Boston, USA
| | - Andre Moreira
- Pulmonary Pathology, New York University Center for Biospecimen Research and Development, New York University, New York, USA
| | - Fred Hirsch
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Maria Urbanowicz
- European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - Iva Brcic
- Institute of Pathology, Medical University of Graz, Austria
| | - Konstanty Korski
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Fabien Gaire
- Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany
| | - Hartmut Koeppen
- Research Pathology, Genentech Inc., South San Francisco, USA
| | - Amy Lo
- Research Pathology, Genentech Inc., South San Francisco, USA
- Department of Pathology, Stanford University, Palo Alto, USA
| | | | - James Ziai
- Research Pathology, Genentech Inc., South San Francisco, USA
| | | | | | - Jiping Zha
- Translational Sciences, MedImmune, Gaithersberg, USA
| | | | | | - Carsten Denkert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jorge Reis-Filho
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Sherene Loi
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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31
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Ramnefjell M, Aamelfot C, Helgeland L, Akslen LA. Low expression of SerpinB2 is associated with reduced survival in lung adenocarcinomas. Oncotarget 2017; 8:90706-90718. [PMID: 29207598 PMCID: PMC5710879 DOI: 10.18632/oncotarget.21456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 09/22/2017] [Indexed: 12/31/2022] Open
Abstract
Lung cancer is a leading cause of cancer deaths worldwide and new biomarkers are of utmost importance. Studies have indicated that the anti-plasminogen activators SerpinB2 and Neuroserpin, and the adhesion molecule L1CAM, have a coordinated impact on development of metastasis. Here, we examined whether expression of these markers was associated with clinico-pathologic characteristics and prognosis in resected non-small cell lung cancer (NSCLC). Surgical specimens from 438 NSCLC patients treated at Haukeland University Hospital, Bergen, Norway (1993-2010) were included (median age 68 years; 213 adenocarcinomas, 135 squamous cell carcinomas, 90 others). Representative tumor sections were stained for SerpinB2, Neuroserpin, and L1CAM. Low expression of SerpinB2 was associated with reduced lung cancer specific survival (LCSS) in adenocarcinomas (p = 0.017), also in stage I (p = 0.031). In contrast, high SerpinB2 was associated with reduced LCSS in stage I squamous cell carcinomas (p = 0.022). Although Neuroserpin and L1CAM showed some associations with clinico-pathologic phenotype, there were no associations with survival. In multivariate survival analysis of adenocarcinomas, low SerpinB2 demonstrated independent prognostic value (HR 1.8, p = 0.008). In summary, low expression of SerpinB2 in lung adenocarcinomas was an independent prognostic factor. In contrast to findings by others, we found no impact of L1CAM on survival. Introduction
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Affiliation(s)
- Maria Ramnefjell
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Christina Aamelfot
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lars Helgeland
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Lars A Akslen
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, Haukeland University Hospital, University of Bergen, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway
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32
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Schenk E, Boland J, Mansfield A, Aubry MC, Dietz A. Local and systemic immunity predict survival in patients with pulmonary sarcomatoid carcinoma. Med Oncol 2017; 34:140. [PMID: 28711968 DOI: 10.1007/s12032-017-1000-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
Pulmonary sarcomatoid cancer (PSC) is a rare, aggressive subtype of non-small cell lung cancer, and measures of local and systemic immunity as biomarkers are incompletely known. We performed this study to characterize the leukocyte composition within the tumor, stroma, and peripheral blood in patients with PSC and correlated our findings with overall survival. Tissue from 30 patients diagnosed with PSC was evaluated by IHC for the presence of CD3+, CD14+, and CD19+ cells and PD-L1 expression. A lymphocyte-to-monocyte ratio (LMR) was calculated for the tumor microenvironment (TME) and peripheral blood. Survival analyses were performed based on IHC scores or groups defined by receiver operating characteristic curve cutoffs. CD3+ and CD14+ cells were found throughout the TME. CD19+ cells were almost exclusive to the stroma and correlated with superior overall survival (HR 0.40, 95% CI 0.21-0.72, p = 0.003). Most patients expressed PD-L1 on the tumor and/or the infiltrating immune cells, but neither the presence nor PD-L1 expression level impacted survival. A more prolific immune infiltration of the TME was associated with improved survival (HR 0.82, 95% CI 0.70-0.98, p = 0.029). PSC patients with a TME LMR ≥1.2 had a median survival of 1598 versus 488 days for a TME LMR <1.2 (p = 0.010). In the peripheral blood, an LMR ≥2.3 was associated with improved median survival (1579 vs. 332 days, p < 0.001). Our data demonstrate multiple measures of the local and systemic immunity are associated with patient survival in PSC.
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Affiliation(s)
- Erin Schenk
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Jennifer Boland
- Department of Laboratory Medicine and Pathology, Divisions of Transfusion Medicine and Experimental Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Marie Christine Aubry
- Department of Laboratory Medicine and Pathology, Divisions of Transfusion Medicine and Experimental Pathology, Mayo Clinic, Rochester, MN, USA
| | - Allan Dietz
- Human Cell Therapy Lab, Divisions of Transfusion Medicine and Experimental Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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33
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Perea F, Bernal M, Sánchez-Palencia A, Carretero J, Torres C, Bayarri C, Gómez-Morales M, Garrido F, Ruiz-Cabello F. The absence of HLA class I expression in non-small cell lung cancer correlates with the tumor tissue structure and the pattern of T cell infiltration. Int J Cancer 2016; 140:888-899. [PMID: 27785783 DOI: 10.1002/ijc.30489] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/22/2016] [Accepted: 10/21/2016] [Indexed: 01/07/2023]
Abstract
We wanted to analyze whether tumor HLA class I (HLA-I) expression influences the pattern of the immune cell infiltration and stromal cell reaction in the tumor microenvironment. Tumor tissues obtained from 57 patients diagnosed with lung carcinomas were analyzed for HLA expression and leukocyte infiltration. 28 patients out of the 57 were completely negative for HLA-I expression (49.1%) or showed a selective HLA-A locus downregulation (three patients, 5.2%). In 26 out of 57 tumors (47.8%) we detected a positive HLA-I expression but with a percentage of HLA-I negative cells between 10 and 25%. The HLA-I negative phenotype was produced by a combination of HLA haplotype loss and a transcriptional downregulation of β2-microglobulin (β2-m) and LMP2 and LMP7 antigen presentation machinery genes. The analysis and localization of different immune cell populations revealed the presence of two major and reproducible patterns. One pattern, which we designated "immune-permissive tumor microenvironment (TME)," was characterized by positive tumor HLA-I expression, intratumoral infiltration with cytotoxic T-CD8+ cells, M1-inflammatory type macrophages, and a diffuse pattern of FAP+ cancer-associated fibroblasts. In contrast, another pattern defined as "non-immune-permissive TME" was found in HLA-I negative tumors with strong stromal-matrix interaction, T-CD8+ cells surrounding tumor nests, a dense layer of FAP+ fibroblasts and M2/repair-type macrophages. In conclusion, this study revealed marked differences between HLA class I-positive and negative tumors related to tissue structure, the composition of leukocyte infiltration and stromal response in the tumor microenvironment.
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Affiliation(s)
- Francisco Perea
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mónica Bernal
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Abel Sánchez-Palencia
- Servicio de Cirugía Torácica, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Javier Carretero
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Cristina Torres
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Clara Bayarri
- Servicio de Cirugía Torácica, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Federico Garrido
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain.,Departamento de Bioquímica, Biología Molecular e Inmunología III, Universidad de Granada, Granada, Spain
| | - Francisco Ruiz-Cabello
- Servicio de Análisis Clínicos e Inmunología, UGC Laboratorio Clínico; Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain.,Departamento de Bioquímica, Biología Molecular e Inmunología III, Universidad de Granada, Granada, Spain
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Romero Vielva L. Tumor lymphocytic infiltration in non-small cell lung cancer: the ultimate prognostic marker? Transl Lung Cancer Res 2016; 5:370-2. [PMID: 27650724 DOI: 10.21037/tlcr.2016.07.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Laura Romero Vielva
- Thoracic Surgery Department, Vall d'Hebron University Hospital, Barcelona, Spain
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35
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Reynders K, De Ruysscher D. Tumor infiltrating lymphocytes in lung cancer: a new prognostic parameter. J Thorac Dis 2016; 8:E833-5. [PMID: 27618931 DOI: 10.21037/jtd.2016.07.75] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kobe Reynders
- Department of Oncology, Experimental Radiation Oncology, KU Leuven-University of Leuven, 3000 Leuven, Belgium
| | - Dirk De Ruysscher
- Department of Oncology, Experimental Radiation Oncology, KU Leuven-University of Leuven, 3000 Leuven, Belgium;; Department of Radiation Oncology, Maastro Clinic, GROW School, Maastricht University Medical Center, Maastricht, The Netherlands
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36
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Lim H, Moon A. Inflammatory fibroblasts in cancer. Arch Pharm Res 2016; 39:1021-31. [DOI: 10.1007/s12272-016-0787-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 06/22/2016] [Indexed: 01/07/2023]
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37
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Brambilla E, Le Teuff G, Marguet S, Lantuejoul S, Dunant A, Graziano S, Pirker R, Douillard JY, Le Chevalier T, Filipits M, Rosell R, Kratzke R, Popper H, Soria JC, Shepherd FA, Seymour L, Tsao MS. Prognostic Effect of Tumor Lymphocytic Infiltration in Resectable Non-Small-Cell Lung Cancer. J Clin Oncol 2016; 34:1223-30. [PMID: 26834066 PMCID: PMC4872323 DOI: 10.1200/jco.2015.63.0970] [Citation(s) in RCA: 246] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Tumor lymphocytic infiltration (TLI) has differing prognostic value among various cancers. The objective of this study was to assess the effect of TLI in lung cancer. PATIENTS AND METHODS A discovery set (one trial, n = 824) and a validation set (three trials, n = 984) that evaluated the benefit of platinum-based adjuvant chemotherapy in non-small-cell lung cancer were used as part of the LACE-Bio (Lung Adjuvant Cisplatin Evaluation Biomarker) study. TLI was defined as intense versus nonintense. The main end point was overall survival (OS); secondary end points were disease-free survival (DFS) and specific DFS (SDFS). Hazard ratios (HRs) and 95% CIs associated with TLI were estimated through a multivariable Cox model in both sets. TLI-histology and TLI-treatment interactions were explored in the combined set. RESULTS Discovery and validation sets with complete data included 783 (409 deaths) and 763 (344 deaths) patients, respectively. Median follow-up was 4.8 and 6 years, respectively. TLI was intense in 11% of patients in the discovery set compared with 6% in the validation set (P < .001). The prognostic value of TLI in the discovery set (OS: HR, 0.56; 95% CI, 0.38 to 0.81; P = .002; DFS: HR, 0.59; 95% CI, 0.42 to 0.83; P = .002; SDFS: HR, 0.56; 95% CI, 0.38 to 0.82; P = .003) was confirmed in the validation set (OS: HR, 0.45; 95% CI, 0.23 to 0.85; P = .01; DFS: HR, 0.44; 95% CI, 0.24 to 0.78; P = .005; SDFS: HR, 0.42; 95% CI, 0.22 to 0.80; P = .008) with no heterogeneity across trials (P ≥ .38 for all end points). No significant predictive effect was observed for TLI (P ≥ .78 for all end points). CONCLUSION Intense lymphocytic infiltration, found in a minority of tumors, was validated as a favorable prognostic marker for survival in resected non-small-cell lung cancer.
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Affiliation(s)
- Elisabeth Brambilla
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada.
| | - Gwénaël Le Teuff
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Sophie Marguet
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Sylvie Lantuejoul
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Ariane Dunant
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Stephen Graziano
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Robert Pirker
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Jean-Yves Douillard
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Thierry Le Chevalier
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Martin Filipits
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Rafael Rosell
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Robert Kratzke
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Helmut Popper
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Jean-Charles Soria
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Frances A Shepherd
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Lesley Seymour
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Ming Sound Tsao
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
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Abstract
Context
Although most primary cancers of the lung carry a heavy mutational load and will potentially present many “nonself” antigens to the immune system, there are a wide range of possible mechanisms for tumors to avoid so-called immune surveillance. One such mechanism is the adoption of immune checkpoints to inhibit the host immune response. Immune checkpoint inhibitors show great promise in the treatment of advanced non–small cell lung cancer.
Objective
—To discuss the possibility of biomarker selection of patients for these therapies. This is becoming a much debated issue, and the immunohistochemical detection of Programmed Death Ligand 1 (PD-L1), the ligand for the inhibitory Programmed Death receptor 1 (PD-1) checkpoint, is one possible biomarker. Data so far available show some conflicting results, but PD-L1 immunohistochemistry looks likely to be introduced into clinical use for selecting patients for treatment with anti–PD-1 or anti–PD-L1 therapies. Given that there are 4 such drugs rapidly approaching regulatory approval, each with its own independent PD-L1 immunohistochemistry biomarker test, both oncologists and pathologists face some significant challenges.
Data Sources
Peer-reviewed literature and meeting proceedings, especially during the last 12 months, were used.
Conclusions
—The biology of PD-1/PD-L1 is complex, the clinical data for these drugs show considerable variation, the selection performance of the PD-L1 biomarker test is not perfect, and the existence of 4 drug/test combinations adds significantly to the problems faced. This article addresses some of the background to this therapeutic problem and discusses some of the issues ahead.
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Affiliation(s)
- Keith M. Kerr
- From the Department of Pathology, Aberdeen University School of Medicine (Dr Kerr), and the Department of Oncology (Dr Nicolson), Aberdeen Royal Infirmary, Aberdeen, United Kingdom
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Bremnes RM, Busund LT, Kilvær TL, Andersen S, Richardsen E, Paulsen EE, Hald S, Khanehkenari MR, Cooper WA, Kao SC, Dønnem T. The Role of Tumor-Infiltrating Lymphocytes in Development, Progression, and Prognosis of Non-Small Cell Lung Cancer. J Thorac Oncol 2016; 11:789-800. [PMID: 26845192 DOI: 10.1016/j.jtho.2016.01.015] [Citation(s) in RCA: 320] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/24/2016] [Accepted: 01/26/2016] [Indexed: 12/25/2022]
Abstract
A malignant tumor is not merely an accumulation of neoplastic cells, but constitutes a microenvironment containing endothelial cells, fibroblasts, structural components, and infiltrating immune cells that impact tumor development, invasion, metastasis, and outcome. Hence, the evolution of cancers reflects intricate cellular and molecular interactions between tumor cells and constituents of the tumor microenvironment. Recent studies have shed new light on this complex interaction between tumor and host immune cells and the resulting immune response. The composition of the immune microenvironment differs across patients as well as in cancers of the same type, including various populations of T cells, B cells, dendritic cells, natural killer cells, myeloid-derived suppressor cells, neutrophils, and macrophages. The type, density, location, and organization of immune cells within solid tumors define the immune contexture, which has proved to be a major determinant of tumor characteristics and patient outcome. Lung cancer consists mostly of non-small cell lung cancer (85%); it is our most deadly malignant disease, with the 5-year survival rate being merely 15%. This review focuses on the immune contexture; the tumor-suppressing roles of tumor-infiltrating lymphocytes; and the relevance of this immune contexture for cancer diagnostics, prognostication, and treatment allocation, with an emphasis on non-small cell lung cancer.
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Affiliation(s)
- Roy M Bremnes
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway.
| | - Lill-Tove Busund
- Institute of Medical Biology, The Arctic University of Norway, Tromsø, Norway; Department of Pathology, University Hospital of Northern Norway, Tromsø, Norway
| | - Thomas L Kilvær
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Sigve Andersen
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Elin Richardsen
- Institute of Medical Biology, The Arctic University of Norway, Tromsø, Norway; Department of Pathology, University Hospital of Northern Norway, Tromsø, Norway
| | - Erna Elise Paulsen
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Sigurd Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | | | - Wendy A Cooper
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; School of Medicine, University of Western Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Steven C Kao
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia; Asbestos Diseases Research Institute, Sydney, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia
| | - Tom Dønnem
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
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Becht E, Giraldo NA, Germain C, de Reyniès A, Laurent-Puig P, Zucman-Rossi J, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH. Immune Contexture, Immunoscore, and Malignant Cell Molecular Subgroups for Prognostic and Theranostic Classifications of Cancers. Adv Immunol 2016; 130:95-190. [DOI: 10.1016/bs.ai.2015.12.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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41
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Donnem T, Kilvaer TK, Andersen S, Richardsen E, Paulsen EE, Hald SM, Al-Saad S, Brustugun OT, Helland A, Lund-Iversen M, Solberg S, Gronberg BH, Wahl SGF, Helgeland L, Fløtten O, Pohl M, Al-Shibli K, Sandanger TM, Pezzella F, Busund LT, Bremnes RM. Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer. Ann Oncol 2015; 27:225-32. [PMID: 26578726 DOI: 10.1093/annonc/mdv560] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 11/07/2015] [Indexed: 02/06/2023] Open
Abstract
Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates and appears highly promising as a supplement to the tumor-node-metastasis (TNM) classification of various tumors. In colorectal cancer, an international task force has initiated prospective multicenter studies aiming to implement TNM-Immunoscore (TNM-I) in a routine clinical setting. In breast cancer, recommendations for the evaluation of tumor-infiltrating lymphocytes (TILs) have been proposed by an international working group. Regardless of promising results, there are potential obstacles related to implementing TNM-I into the clinic. Diverse methods may be needed for different malignancies and even within each cancer entity. Nevertheless, a uniform approach across malignancies would be advantageous. In nonsmall-cell lung cancer (NSCLC), there are several previous reports indicating an apparent prognostic importance of TILs, but studies on TILs in a TNM-I setting are sparse and no general recommendations are made. However, recently published data is promising, evoking a realistic hope of a clinical useful NSCLC TNM-I. This review will focus on the TNM-I potential in NSCLC and propose strategies for clinical implementation of a TNM-I in resected NSCLC.
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Affiliation(s)
- T Donnem
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - T K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso
| | - S Andersen
- Department of Oncology, University Hospital of North Norway, Tromso
| | - E Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - E E Paulsen
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - S M Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromso
| | - S Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - O T Brustugun
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - A Helland
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo Department of Cancer Genetics, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - M Lund-Iversen
- Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo
| | - S Solberg
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo
| | - B H Gronberg
- The Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim Department of Cancer Research and Molecular Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim
| | - S G F Wahl
- Department of Pathology and Medical Genetics, St Olavs Hospital-Trondheim University Hospital, Trondheim
| | - L Helgeland
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - O Fløtten
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - M Pohl
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - K Al-Shibli
- Department of Pathology, Nordland Hospital, Bodo
| | - T M Sandanger
- Department of Community Medicine, The Artic University of Tromso, Tromso, Norway
| | - F Pezzella
- Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - L T Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso
| | - R M Bremnes
- Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso
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42
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Zhu LX, Davoodi M, Srivastava MK, Kachroo P, Lee JM, St John M, Harris-White M, Huang M, Strieter RM, Dubinett S, Sharma S. GITR agonist enhances vaccination responses in lung cancer. Oncoimmunology 2015; 4:e992237. [PMID: 26137407 DOI: 10.4161/2162402x.2014.992237] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 11/24/2014] [Indexed: 01/22/2023] Open
Abstract
An immune tolerant tumor microenvironment promotes immune evasion of lung cancer. Agents that antagonize immune tolerance will thus aid the fight against this devastating disease. Members of the tumor necrosis factor receptor (TNFR) family modulate the magnitude, duration and phenotype of immune responsiveness to antigens. Among these, GITR expressed on immune cells functions as a key regulator in inflammatory and immune responses. Here, we evaluate the GITR agonistic antibody (DTA-1) as a mono-therapy and in combination with therapeutic vaccination in murine lung cancer models. We found that DTA-1 treatment of tumor-bearing mice increased: (i) the frequency and activation of intratumoral natural killer (NK) cells and T lymphocytes, (ii) the antigen presenting cell (APC) activity in the tumor, and (iii) systemic T-cell specific tumor cell cytolysis. DTA-1 treatment enhanced tumor cell apoptosis as quantified by cleaved caspase-3 staining in the tumors. DTA-1 treatment increased expression of IFNγ, TNFα and IL-12 but reduced IL-10 levels in tumors. Furthermore, increased anti-angiogenic chemokines corresponding with decreased pro-angiogenic chemokine levels correlated with reduced expression of the endothelial cell marker Meca 32 in the tumors of DTA-1 treated mice. In accordance, there was reduced tumor growth (8-fold by weight) in the DTA-1 treatment group. NK cell depletion markedly inhibited the antitumor response elicited by DTA-1. DTA-1 combined with therapeutic vaccination caused tumor rejection in 38% of mice and a 20-fold reduction in tumor burden in the remaining mice relative to control. Mice that rejected tumors following therapy developed immunological memory against subsequent re-challenge. Our data demonstrates GITR agonist antibody activated NK cell and T lymphocyte activity, and enhanced therapeutic vaccination responses against lung cancer.
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Key Words
- APC
- APC, antigen presenting cell
- Ab, antibody
- BMA, bone marrow adherent
- CTL, cytotoxic T lymphocyte
- DC, dendritic cell
- DTA-1, anti-GITR antibody
- ERK, extracellular signal-regulated kinase
- GITR, glucocorticoid‐induced TNFR‐related gene;IFNγ, interferon γ
- JNK, janus kinase
- MAPK, mitogen-activated protein kinase
- MDSC, myeloid derived suppressor cell
- NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NK
- NK, natural killer
- P38, p38 mitogen-activated protein kinase(s)
- PD-1, programmed cell death protein 1
- PD-L1, programmed cell death ligand 1;TNFα, Interferon Alpha
- T cell activation
- TCR, T cell receptor
- TNFR, tumor necrosis factor receptor
- Treg, regulatory T cell
- lung cancer
- vaccination responses
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Affiliation(s)
- Li X Zhu
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA
| | - Michael Davoodi
- Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA
| | - Minu K Srivastava
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA
| | - Puja Kachroo
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Jonsson Comprehensive Cancer Center; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA
| | - Jay M Lee
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA ; Jonsson Comprehensive Cancer Center; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA
| | - Maie St John
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Jonsson Comprehensive Cancer Center; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA
| | - Marni Harris-White
- Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA
| | - Min Huang
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA
| | - Robert M Strieter
- Department of Medicine; University of Virginia ; Charlottesville, VA USA
| | - Steven Dubinett
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA ; Jonsson Comprehensive Cancer Center; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA
| | - Sherven Sharma
- Department of Medicine; UCLA Lung Cancer Research Program ; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA ; Molecular Gene Medicine Laboratory; Veterans Affairs Greater Los Angeles Healthcare System ; Los Angeles, CA USA ; Jonsson Comprehensive Cancer Center; David Geffen School of Medicine at UCLA ; Los Angeles, CA USA
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Remark R, Becker C, Gomez JE, Damotte D, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH, Powell CA, Altorki NK, Merad M, Gnjatic S. The non-small cell lung cancer immune contexture. A major determinant of tumor characteristics and patient outcome. Am J Respir Crit Care Med 2015; 191:377-90. [PMID: 25369536 DOI: 10.1164/rccm.201409-1671pp] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Solid tumors, beyond mere accumulation of cancer cells, form a complex ecosystem consisting of normal epithelial cells, fibroblasts, blood and lymphatic vessels, structural components, and infiltrating hematopoietic cells including myeloid and lymphoid elements that impact tumor growth, tumor spreading, and clinical outcome. The composition of the immune microenvironment is diverse, including various populations of T cells, B cells, dendritic cells, natural killer cells, myeloid-derived suppressor cells, neutrophils, or macrophages. The immune contexture describes the density, location, and organization of these immune cells within solid tumors. In lung cancer, which is the deadliest type of cancer, and particularly in non-small cell lung cancer, its most prevalent form, reports have described some of the interactions between the tumor and the host. These data, in addition to articles on various types of tumors, provide a greater understanding of the tumor-host microenvironment interaction and stimulate the development of prognostic and predictive biomarkers, the identification of novel target antigens for therapeutic intervention, and the implementation of tools for long-term management of patients with cancer.
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Butts CA. Anti-tumor immune response in early stage non small cell lung cancer (NSCLC): implications for adjuvant therapy. Transl Lung Cancer Res 2015; 2:415-22. [PMID: 25806261 DOI: 10.3978/j.issn.2218-6751.2013.10.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 10/12/2013] [Indexed: 11/14/2022]
Abstract
The demonstration that systemic chemotherapy improves survival in patients who have had resection of early stage non-small cell lung cancer (NSCLC) represents a significant advance. The absolute benefit of adjuvant chemotherapy in this setting is small with an overall survival improvement of 5%. In addition, there are many patients who have contraindications to cisplatin-based adjuvant therapy. Adjuvant chemotherapy is intended to target systemic micrometastases that remain after primary resection. The observation that cancers can relapse months or years after initial surgery implies that the residual micrometastases exist in a latent or dormant state. The concept of tumor dormancy offers therapeutic potential through induction or maintenance of the dormant state in disseminated tumor cells or through eradication of these dormant cells. Cancer dormancy is a complex process with multiple potential mechanisms. This review will focus on some of the evidence for immune related tumor dormancy and the potential for immune therapies to improve outcomes in the adjuvant setting in NSCLC.
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Affiliation(s)
- Charles A Butts
- Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
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45
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Qi L, Li B, Dong Y, Xu H, Chen L, Wang H, Li P, Zhao W, Gu Y, Wang C, Guo Z. Deconvolution of the gene expression profiles of valuable banked blood specimens for studying the prognostic values of altered peripheral immune cell proportions in cancer patients. PLoS One 2014; 9:e100934. [PMID: 24959668 PMCID: PMC4069164 DOI: 10.1371/journal.pone.0100934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 06/01/2014] [Indexed: 12/15/2022] Open
Abstract
Background The altered composition of immune cells in peripheral blood has been reported to be associated with cancer patient survival. However, analysis of the composition of peripheral immune cells are often limited in retrospective survival studies employing banked blood specimens with long-term follow-up because the application of flow cytometry to such specimens is problematic. The aim of this study was to demonstrate the feasibility of deconvolving blood-based gene expression profiles (GEPs) to estimate the proportions of immune cells and determine their prognostic values for cancer patients. Methods and Results Here, using GEPs from peripheral blood mononuclear cells (PBMC) of 108 non-small cell lung cancer (NSCLC) patients, we deconvolved the immune cell proportions and analyzed their association with patient survival. Univariate Kaplan-Meier analysis showed that a low proportion of T cells was significantly associated with poor patient survival, as was the proportion of T helper cells; however, only the proportion of T cells was independently prognostic for patients by a multivariate Cox regression analysis (hazard ratio = 2.23; 95% CI, 1.01–4.92; p = .048). Considering that altered peripheral blood compositions can reflect altered immune responses within the tumor microenvironment, based on a tissue-based GEPs of NSCLC patients, we demonstrated a significant association between poor patient survival and the low level of antigen presentation, which play a critical role in T cell proliferation. Conclusions These results demonstrate that it is feasible to deconvolve GEPs from banked blood specimens for retrospective survival analysis of alterations of immune cell composition, and suggest the proportion of T cells in PBMC which might reflect the antigen presentation level within the tumor microenvironment can be a prognostic marker for NSCLC patients.
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Affiliation(s)
- Lishuang Qi
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Bailiang Li
- College of Pharmacy, Harbin Medical University, Harbin, China
| | - Yu Dong
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Hui Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Libin Chen
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Hongwei Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Pengfei Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Wenyuan Zhao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yunyan Gu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Chenguang Wang
- College of Pharmacy, Harbin Medical University, Harbin, China
- * E-mail: (CW); (ZG)
| | - Zheng Guo
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
- Department of Bioinformatics, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
- * E-mail: (CW); (ZG)
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46
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Affiliation(s)
- Keith M. Kerr
- Aberdeen University Medical School, Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Marianne C. Nicolson
- Aberdeen University Medical School, Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, UK
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47
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Fang L, Lowther DE, Meizlish ML, Anderson RCE, Bruce JN, Devine L, Huttner AJ, Kleinstein SH, Lee JY, Stern JNH, Yaari G, Lovato L, Cronk KM, O'Connor KC. The immune cell infiltrate populating meningiomas is composed of mature, antigen-experienced T and B cells. Neuro Oncol 2013; 15:1479-90. [PMID: 23978377 DOI: 10.1093/neuonc/not110] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Meningiomas often harbor an immune cell infiltrate that can include substantial numbers of T and B cells. However, their phenotype and characteristics remain undefined. To gain a deeper understanding of the T and B cell repertoire in this tumor, we characterized the immune infiltrate of 28 resected meningiomas representing all grades. METHODS Immunohistochemistry was used to grossly characterize and enumerate infiltrating lymphocytes. A molecular analysis of the immunoglobulin variable region of tumor-infiltrating B cells was used to characterize their antigen experience. Flow cytometry of fresh tissue homogenate and paired peripheral blood lymphocytes was used to identify T cell phenotypes and characterize the T cell repertoire. RESULTS A conspicuous B and T cell infiltrate, primarily clustered in perivascular spaces, was present in the microenvironment of most tumors examined. Characterization of 294 tumor-infiltrating B cells revealed clear evidence of antigen experience, in that the cardinal features of an antigen-driven B cell response were present. Meningiomas harbored populations of antigen-experienced CD4+ and CD8+ memory/effector T cells, regulatory T cells, and T cells expressing the immune checkpoint molecules PD-1 and Tim-3, indicative of exhaustion. All of these phenotypes were considerably enriched relative to their frequency in the circulation. The T cell repertoire in the tumor microenvironment included populations that were not reflected in paired peripheral blood. CONCLUSION The tumor microenvironment of meningiomas often includes postgerminal center B cell populations. These tumors invariably include a selected, antigen-experienced, effector T cell population enriched by those that express markers of an exhausted phenotype.
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Affiliation(s)
- Liangjuan Fang
- Corresponding Author: Dr. Kevin C. O'Connor, PhD, Yale School of Medicine, 300 George Street, Room 353J, New Haven, CT, USA 06511..
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48
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Ganesan AP, Johansson M, Ruffell B, Beltran A, Lau J, Jablons DM, Coussens LM. Tumor-infiltrating regulatory T cells inhibit endogenous cytotoxic T cell responses to lung adenocarcinoma. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2013; 191:2009-17. [PMID: 23851682 PMCID: PMC3774528 DOI: 10.4049/jimmunol.1301317] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Immune cells comprise a substantial proportion of the tumor mass in human nonsmall cell lung cancers (NSCLC), but the precise composition and significance of this infiltration are unclear. In this study, we examined immune complexity of human NSCLC as well as NSCLC developing in CC10-TAg transgenic mice, and revealed that CD4(+) T lymphocytes represent the dominant population of CD45(+) immune cells, and, relative to normal lung tissue, CD4(+)Foxp3(+) regulatory T cells (Tregs) were significantly increased as a proportion of total CD4(+) cells. To assess the functional significance of increased Tregs, we evaluated CD8(+) T cell-deficient/CC10-TAg mice and revealed that CD8(+) T cells significantly controlled tumor growth with antitumor activity that was partially repressed by Tregs. However, whereas treatment with anti-CD25-depleting mAb as monotherapy preferentially depleted Tregs and improved CD8(+) T cell-mediated control of tumor progression during early tumor development, similar monotherapy was ineffective at later stages. Because mice bearing early NSCLC treated with anti-CD25 mAb exhibited increased tumor cell death associated with infiltration by CD8(+) T cells expressing elevated levels of granzyme A, granzyme B, perforin, and IFN-γ, we therefore evaluated carboplatin combination therapy resulting in a significantly extended survival beyond that observed with chemotherapy alone, indicating that Treg depletion in combination with cytotoxic therapy may be beneficial as a treatment strategy for advanced NSCLC.
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MESH Headings
- Adenocarcinoma/immunology
- Animals
- Antibodies, Monoclonal/therapeutic use
- Antineoplastic Agents, Alkylating/administration & dosage
- Antineoplastic Agents, Alkylating/therapeutic use
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/pathology
- Carboplatin/administration & dosage
- Carboplatin/therapeutic use
- Carcinoma, Non-Small-Cell Lung/immunology
- Cisplatin/therapeutic use
- Cisplatin/toxicity
- Cytotoxicity, Immunologic
- Humans
- Interleukin-2 Receptor alpha Subunit/immunology
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Lymphocyte Count
- Lymphocyte Depletion
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/pathology
- Lymphopenia/genetics
- Lymphopenia/immunology
- Mice
- Mice, Mutant Strains
- Mice, Transgenic
- Random Allocation
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/pathology
- T-Lymphocytes, Cytotoxic/immunology
- T-Lymphocytes, Cytotoxic/pathology
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/pathology
- Tumor Escape
- Tumor Microenvironment/immunology
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Affiliation(s)
- Anusha-Preethi Ganesan
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
- Cancer Sciences Division, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
| | - Magnus Johansson
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Brian Ruffell
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Adam Beltran
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94143, USA
- Department of Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jonathan Lau
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David M. Jablons
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
- Department of Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Lisa M. Coussens
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94143, USA
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49
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Wang W, Hodkinson P, McLaren F, Mackean MJ, Williams L, Howie SEM, Wallace WAH, Sethi T. Histologic assessment of tumor-associated CD45(+) cell numbers is an independent predictor of prognosis in small cell lung cancer. Chest 2013; 143:146-151. [PMID: 22847040 DOI: 10.1378/chest.12-0681] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Small cell lung carcinoma (SCLC) continues to have a poor prognosis, with a 2-year survival of < 20%. Studies have suggested that SCLC may affect the immune system to allow it to evade immunologic responses. We hypothesized that any such effect would be characterized by a decrease in the lymphoid cells associated with the tumor in biopsy specimens and that this might relate to patient outcome. METHODS Sixty-four SCLC biopsy specimens were immunohistochemically stained with anti-CD45 antibody to identify immune cells associated with the tumor. A mean CD45 count per high-power field for each case was obtained, and the results were correlated with age, sex, stage, performance status (PS), treatment with chemotherapy/radiotherapy, and overall survival. RESULTS The median CD45 count for all cases was taken as 40 (CD45(40)). Kaplan-Meier plots demonstrated better survival for patients with a CD45(40) > 40 ( P < .009). No relationship between CD45 40 and age, sex, stage, or treatment by chemotherapy or radiotherapy was identified. Although PS was a significant predictor of survival ( P = .014), it did not correlate with CD45 40. In patients with better Eastern Cooperative Oncology Group PS (≤ 2), the CD45(40) demonstrated a highly significant survival advantage for those with CD45(40) > 40 ( P < .0001). CONCLUSIONS The data indicate that (1) simple immunohistochemical assessment of immune cell infiltrates in routinely processed and stained biopsy specimens of primary tumors can provide prognostic information in SCLC and (2) tumor-associated CD45(+) cells in SCLC biopsy specimens may be a good clinical marker to identify patients with poor prognosis despite good PS.
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Affiliation(s)
- Wei Wang
- Department of Respiratory Medicine and Allergy, King's College London, London, England; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland
| | - Philip Hodkinson
- Department of Respiratory Medicine, Crosshouse Hospital, Kilmarnock; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland
| | - Fiona McLaren
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland
| | - Melanie J Mackean
- Department of Medical Oncology, Edinburgh Cancer Centre, Edinburgh, Scotland
| | - Linda Williams
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland
| | - Sarah E M Howie
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland
| | - William A H Wallace
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland; Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| | - Tariq Sethi
- Department of Respiratory Medicine and Allergy, King's College London, London, England; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
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50
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The emerging role of T cell cytokines in non-small cell lung cancer. Cytokine Growth Factor Rev 2012; 23:315-22. [DOI: 10.1016/j.cytogfr.2012.08.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 08/20/2012] [Indexed: 01/29/2023]
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