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Crossey F, Marx S, Hölters S, Schmitt K, Bohle RM, Schmidt T, Stöckle M, Sester U, Sester M, Janssen MWW. Robust method for isolation of tumor infiltrating lymphocytes with a high vital cell yield from small samples of renal cell carcinomas by a new collagenase-free mechanical procedure. Urol Oncol 2018; 36:402.e1-402.e10. [PMID: 30072305 DOI: 10.1016/j.urolonc.2018.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Tumor-infiltrating lymphocytes (TIL) play an important role in the pathogenesis of renal cell carcinoma. Characterization of TIL requires efficient isolation procedures, especially in early stage disease when the tumor is of small in size. Conventional methods for isolating TIL are based on enzymatic tissue digestion, most frequently with collagenase. Collagenase isolation is limited by poor cell recovery, altered expression of cell-surface molecules, and impaired TIL-functionality. To overcome these limitations, we developed and optimized conditions for a robust collagenase-free mechanical procedure for improved isolation of TIL from renal cell carcinoma samples. METHODS TIL from tumor samples and T cells from peripheral blood were collected from 12 patients undergoing partial or radical nephrectomy. Samples were subjected to an enzymatic reference protocol and to a newly established mechanical isolation protocol. After viability staining, TIL-subpopulations were quantified and phenotyped by immunohistochemistry and flow-cytometric analysis, and were compared to characteristics of peripheral blood T cells. As a marker for TIL-functionality, T-cell cytokine induction was quantified after polyclonal stimulation. RESULTS We show that this new technique is rapid and allows identification of CD4 and CD8 T-cell subpopulations including CD4, CD8, and regulatory T cells expressing anergy markers such as programmed death-1 (PD-1) or B- and T-lymphocyte attenuator. When compared to the reference protocol involving collagenase digestion, the yield of TIL after mechanical isolation was higher and the expression of cell-surface markers was better preserved. Moreover, although antitumor activity was not assessed, mechanically isolated TIL are at least equally functional as T cells from peripheral blood, as polyclonal stimulation induced cytokines such as interferon-γ and tumor necrosis factor-α in both TIL and T cells from peripheral blood. CONCLUSION The mechanical procedure may be applied as a robust and rapid alternative to collagenase digestion for isolation of high amounts of phenotypically and functionally intact TIL from fresh tumor samples.
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Affiliation(s)
- Fiona Crossey
- Department of Urology and Pediatric Urology, Saarland University, Homburg (Saar), Germany; Department of Transplant and Infection Immunology, Saarland University, Homburg (Saar), Germany.
| | - Stefanie Marx
- Department of Transplant and Infection Immunology, Saarland University, Homburg (Saar), Germany.
| | - Sebastian Hölters
- Department of Urology and Pediatric Urology, Saarland University, Homburg (Saar), Germany.
| | - Kai Schmitt
- Department of Pathology, Saarland University, Homburg (Saar), Germany.
| | - Rainer M Bohle
- Department of Pathology, Saarland University, Homburg (Saar), Germany.
| | - Tina Schmidt
- Department of Transplant and Infection Immunology, Saarland University, Homburg (Saar), Germany.
| | - Michael Stöckle
- Department of Urology and Pediatric Urology, Saarland University, Homburg (Saar), Germany.
| | - Urban Sester
- Department of Internal Medicine IV, Saarland University, Homburg (Saar), Germany.
| | - Martina Sester
- Department of Transplant and Infection Immunology, Saarland University, Homburg (Saar), Germany.
| | - Martin W W Janssen
- Department of Urology and Pediatric Urology, Saarland University, Homburg (Saar), Germany; Department of Transplant and Infection Immunology, Saarland University, Homburg (Saar), Germany.
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Villa NM, Farahmand A, Du L, Yeh MW, Smooke-Praw S, Ribas A, Chmielowski B, Cherry G, Leung AM. Endocrinopathies with use of cancer immunotherapies. Clin Endocrinol (Oxf) 2018; 88:327-332. [PMID: 28941311 PMCID: PMC5771947 DOI: 10.1111/cen.13483] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 09/03/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Immunomodulatory therapies, including CTLA-4 and PD-1 inhibitors, provide a directed attack against cancer cells by preventing T cell deactivation. However, these drugs also prevent the downregulation of auto-reactive T cells, resulting in immune-related adverse events (IRAEs). Reports show a varied incidence of endocrine IRAEs, ranging from 0% to 63%. OBJECTIVE To describe the frequency and clinical characteristics of endocrine IRAEs in patients taking cancer immunomodulatory therapies. DESIGN Retrospective cohort study. PATIENTS A total of 388 patients aged ≥18 years who were prescribed ipilimumab, nivolumab and/or pembrolizumab between 2009 and 2016 at our institution. MEASUREMENTS Biochemical criteria were used to define endocrine IRAEs, including thyroid, pituitary, pancreas and adrenal dysfunction, following use of immunomodulatory therapies. RESULTS Fifty endocrine IRAEs occurred in our cohort, corresponding to a rate of 12.9%. The most common endocrine IRAEs were thyroid dysfunction (11.1%), with a lower incidence of pituitary dysfunction (1.8% of patients). CONCLUSIONS Over 12% of patients receiving ipilimumab, nivolumab and/or pembrolizumab in our study sample developed an endocrine IRAE. Patients who undergo treatment with immunomodulatory therapies should be monitored for the development of endocrine IRAEs.
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Affiliation(s)
| | - Abtin Farahmand
- Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Lin Du
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California
| | - Michael W. Yeh
- Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Stephanie Smooke-Praw
- Division of Endocrinology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Antoni Ribas
- Division of Hematology and Oncology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Bartosz Chmielowski
- Division of Hematology and Oncology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Grace Cherry
- Division of Hematology and Oncology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Angela M. Leung
- Division of Endocrinology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
- Division of Endocrinology, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California
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Bonavida B, Chouaib S. Resistance to anticancer immunity in cancer patients: potential strategies to reverse resistance. Ann Oncol 2017; 28:457-467. [PMID: 27864216 DOI: 10.1093/annonc/mdw615] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In the 1990s, the application of immunotherapy approaches to target cancer cells resulted in significant clinical responses in patients with advanced malignancies who were refractory to conventional therapies. While early immunotherapeutics were focused on T cell-mediated cytotoxic activity, subsequent efforts were centered on targeted antibody-mediated anticancer therapy. The initial success with antibody therapy encouraged further studies and, consequently, there are now more than 25 FDA-approved antibodies directed against a range of targets. Although both T cell and antibody therapies continue to result in significant clinical responses with minimal toxicity, a significant subset of patients does not respond to immunotherapy and another subset develops resistance following an initial response. This review is focused on describing examples showing that cancer resistance to immunotherapies indeed occurs. In addition, it reviews the mechanisms being used to overcome the resistance to immunotherapies by targeting the tumor cell directly and/or the tumor microenvironment.
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Affiliation(s)
- B Bonavida
- Department of Microbiology, Immunology and Molecular Genetics, Jonsson Comprehensive Cancer Center and David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - S Chouaib
- Institut de Cancérologie Gustave Roussy, Inserm U1186, Immunologie Intégrative et Oncogénétique, Institut Gustave Roussy, Université Paris-Sud, Université Paris-Saclay Villejuif, France
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Champion L, Culine S, Desgranchamps F, Benali K, Verine J, Daugas E. Metastatic Renal Cell Carcinoma in a Renal Allograft: A Sustained Complete Remission After Stimulated Rejection. Am J Transplant 2017; 17:1125-1128. [PMID: 27931087 DOI: 10.1111/ajt.14151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/04/2016] [Accepted: 11/22/2016] [Indexed: 01/25/2023]
Abstract
We report the case of a 40-year-old woman who recovered from a diffuse metastatic renal cell carcinoma that developed from a kidney allograft. She was successfully treated by the induction of tumor rejection. Immunosuppression was discontinued, and transplant nephrectomy was deliberately delayed based on the expectation that the tumor mass would trigger the alloimmune response, which was stimulated with pegylated interferon-α-2a. Three years later, the patient remained in complete remission. Despite this severe context, the present case shows that the poor prognosis of allograft metastatic renal cell carcinoma could be dramatically reversed by taking advantage of the donor tumor origin to actively induce a specific alloimmune rejection of the tumor.
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Affiliation(s)
- L Champion
- Department of Nephrology, AP-HP, DHU FIRE, Bichat Hospital, Paris, France
| | - S Culine
- Department of Medical Oncology, APHP, Saint Louis Hospital, Paris, France
| | - F Desgranchamps
- Department of Urology, APHP, Saint Louis Hospital, Paris, France
| | - K Benali
- Department of Nuclear Medicine, AP-HP, Bichat Hospital, Paris, France
| | - J Verine
- Department of Pathology, AP-HP, Saint Louis Hospital, Paris, France
| | - E Daugas
- Department of Nephrology, AP-HP, DHU FIRE, Bichat Hospital, Paris, France
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Rakhmilevich AL, Felder M, Lever L, Slowinski J, Rasmussen K, Hoefges A, Van De Voort TJ, Loibner H, Korman AJ, Gillies SD, Sondel PM. Effective Combination of Innate and Adaptive Immunotherapeutic Approaches in a Mouse Melanoma Model. THE JOURNAL OF IMMUNOLOGY 2017; 198:1575-1584. [PMID: 28062694 DOI: 10.4049/jimmunol.1601255] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/02/2016] [Indexed: 01/06/2023]
Abstract
Most cancer immunotherapies include activation of either innate or adaptive immune responses. We hypothesized that the combined activation of both innate and adaptive immunity will result in better antitumor efficacy. We have previously shown the synergy of an agonistic anti-CD40 mAb (anti-CD40) and CpG-oligodeoxynucleotides in activating macrophages to induce tumor cell killing in mice. Separately, we have shown that a direct intratumoral injection of immunocytokine (IC), an anti-GD2 Ab linked to IL-2, can activate T and NK cells resulting in antitumor effects. We hypothesized that activation of macrophages with anti-CD40/CpG, and NK cells with IC, would cause innate tumor destruction, leading to increased presentation of tumor Ags and adaptive T cell activation; the latter could be further augmented by anti-CTLA-4 Ab to achieve tumor eradication and immunological memory. Using the mouse GD2+ B78 melanoma model, we show that anti-CD40/CpG treatment led to upregulation of T cell activation markers in draining lymph nodes. Anti-CD40/CpG + IC/anti-CTLA-4 synergistically induced regression of advanced s.c. tumors, resulting in cure of some mice and development of immunological memory against B78 and wild type B16 tumors. Although the antitumor effect of anti-CD40/CpG did not require T cells, the antitumor effect of IC/anti-CTLA-4 was dependent on T cells. The combined treatment with anti-CD40/CpG + IC/anti-CTLA-4 reduced T regulatory cells in the tumors and was effective against distant solid tumors and lung metastases. We suggest that a combination of anti-CD40/CpG and IC/anti-CTLA-4 should be developed for clinical testing as a potentially effective novel immunotherapy strategy.
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Affiliation(s)
- Alexander L Rakhmilevich
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705; .,Paul P. Carbone Comprehensive Cancer Center, Madison, WI 53705
| | - Mildred Felder
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI 53705
| | - Lauren Lever
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705
| | - Jacob Slowinski
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705
| | - Kayla Rasmussen
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705
| | - Anna Hoefges
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705
| | | | | | - Alan J Korman
- Bristol-Myers Squibb Company, Redwood City, CA 94063
| | | | - Paul M Sondel
- Department of Human Oncology, University of Wisconsin, Madison, WI 53705.,Paul P. Carbone Comprehensive Cancer Center, Madison, WI 53705.,Department of Pediatrics, University of Wisconsin, Madison, WI 53705
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Affiliation(s)
- Adil I Daud
- University of California, San Francisco, 1600 Divisadero St, San Francisco, CA 94143, USA
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