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TLR agonist rMBP-NAP inhibits B16 melanoma tumor growth via induction of DCs maturation and T-cells cytotoxic response. Cytotechnology 2022; 74:459-467. [PMID: 36110155 PMCID: PMC9374861 DOI: 10.1007/s10616-022-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/15/2022] [Indexed: 11/03/2022] Open
Abstract
Melanoma is the most aggressive skin cancer with increasing incidence and poor prognosis all over the world. Recent research has found that immunological abnormalities played a key role in the pathogenesis of melanoma. Increased understanding of tumor immune mechanisms has led to attract more attention for the potential of TLR agonists on treatment of melanoma. The present study aimed to determine the potential and efficacy of a novel TLR agonist rMBP-NAP for antitumor treatment in murine model of B16 melanoma. Subcutaneous administration of mice with rMBP-NAP remarkably inhibited tumor growth and tumor inhibitory rate was 77.72%. Additionally, rMBP‑NAP significantly upregulated the number of mature DCs (P < 0.05). Furthermore, the number and activation of CD4+ and CD8+ T cells were prominently enhanced following rMBP-NAP stimulation (P < 0.05). Overall, these results demonstrated that rMBP-NAP possessed the potential to be a novel immunomodulatory candidate drug for treating melanoma.
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Saini K, Chee P. Treatment of locally advanced cutaneous Merkel cell carcinoma with topical imiquimod. JAAD Case Rep 2021; 13:121-123. [PMID: 34195321 PMCID: PMC8237241 DOI: 10.1016/j.jdcr.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Komal Saini
- Valentine Dermatology, Valentine, New South Wales.,Department of Dermatology, John Hunter Hospital, Newcastle, New South Wales
| | - Paul Chee
- Valentine Dermatology, Valentine, New South Wales.,Department of Dermatology, John Hunter Hospital, Newcastle, New South Wales
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Abstract
Skin cancer, as the most physically accessible malignancy, allows for the greatest variety in treatment innovation. The last 2 decades have seen striking increases in the life expectancies of those diagnosed with malignant melanoma. However, many cases remain in which disease prevails against standard treatment, and those patients rely on continuing ingenuity. Drugs that can be injected directly into patients' tumors have become increasingly promising, not least for the reduction in side effects observed. Intratumoral therapy encompasses a wide array of agents, from chemotherapeutic drugs to cancer vaccines. While each show some efficacy, those agents which regulate the immune system likely have the greatest potential for preventing disease progression or recurrence. Recent research has highlighted the importance of the presence of cytotoxic T cells and of keeping regulatory T cells in check. Thus, manipulating the tumor microenvironment is a need in skin cancer therapy, which intratumoral delivery can potentially address. In order to find the best approach to each person's disease, more studies are needed to test intralesional agents in combination with currently approved therapies and with each other.
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Villani A, Fabbrocini G, Costa C, Carmela Annunziata M, Scalvenzi M. Merkel Cell Carcinoma: Therapeutic Update and Emerging Therapies. Dermatol Ther (Heidelb) 2019; 9:209-222. [PMID: 30820877 PMCID: PMC6522614 DOI: 10.1007/s13555-019-0288-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Indexed: 02/08/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine skin cancer whose incidence has almost doubled in recent decades. Risk factors for MCC include age > 65 years, immunosuppression, sun exposure and infection by Merkel cell polyomavirus. MCC usually presents as rapidly growing, firm, red to violaceous nodule localized on the sun-exposed skin. Surgery followed by radiation therapy is considered to be the first-line treatment for primary or loco-regional MCC in order to prevent recurrences and lymph node metastasis, while chemotherapy has always been used to treat advanced forms. However, responses to chemotherapy are mostly of short duration, and the associated clinical benefit on overall survival is still unclear. The use of checkpoint inhibitors (CPIs) has shown good results in the treatment of advanced MCC and, consequently, CPIs are considered emerging immunotherapeutic options for these patients, although there are still no standardized treatments for patients with metastatic disease. Here we present a complete overview of the different possibilities for the treatment of MCC according to the stage of the disease, focusing on the emerging immunotherapies used for treating advanced MCC.
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Affiliation(s)
- Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy.
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy
| | - Claudia Costa
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy
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Abstract
Merkel cell carcinoma is an aggressive neuroendocrine carcinoma with increasing incidence over the past few decades. The TNM Staging System used for Merkel cell carcinoma was updated by the American Joint Committee on Cancer in 2017. Clinical practice guidelines were updated by the National Comprehensive Cancer Network on August 31, 2018. This article reviews the most recent evidence-based updates on staging and management.
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Affiliation(s)
- Christine Cornejo
- Department of Dermatology, University of Pennsylvania, 2 Maloney Building, 3600 Spruce Street, Philadelphia, PA 19104, USA
| | - Christopher J Miller
- Department of Dermatology, Perelman Center for Advanced Medicine, University of Pennsylvania, 1st Floor South Pavilion, 3400 Civic Center Boulevard, Suite 1-330S, Philadelphia, PA 19104, USA.
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Tétu P, Baroudjian B, Madelaine I, Delyon J, Lebbé C. [Update in treatment for Merkel Cell Carcinoma and clinical practice guide]. Bull Cancer 2018; 106:64-72. [PMID: 30579571 DOI: 10.1016/j.bulcan.2018.11.009] [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: 09/22/2018] [Revised: 10/31/2018] [Accepted: 11/06/2018] [Indexed: 12/30/2022]
Abstract
Merkel Cell Carcinoma (MCC) is a rare neuroendocrine skin cancer that is associated with frequent recurrences and a high mortality rate. In the recent past years, incidence rates of MCC have increased in the USA, Australia and Europe. About one third of patients present metastatic disease at the time of diagnosis or will develop metastases in the course of their disease. Although advanced MCC is chemosensitive, responses to cytotoxic chemotherapy are mostly of short duration and toxicity is potentially high. Recently, considerable progress has been made in the MCC field with the arrival of immunotherapy, particularly anti-PD-1 and anti-PD-L1 antibodies which have demonstrated impressive frequency and durability of response and were well-tolerated. However, about 50 % of advanced patients do not respond to immunotherapy and urgent need exists to identify biomarkers and predictive factors. Moreover, many randomized prospective studies are evaluating the efficacy and safety of novel therapeutics and patients with advanced stages are encouraged to participate in clinical trials. This article synthetizes the actual clinical practice guidelines, the safety and efficacy data from the recent clinical trials and the on-going clinical trials to help clinicians in the treatment of MCC patients.
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Affiliation(s)
- Pauline Tétu
- AP-HP Dermatology, hôpital Saint-Louis, Paris 7 Diderot University, Department of Dermatology, Inserm U976, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Barouyr Baroudjian
- AP-HP Dermatology, hôpital Saint-Louis, Paris 7 Diderot University, Department of Dermatology, Inserm U976, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Isabelle Madelaine
- AP-HP Pharmacology, hôpital Saint-Louis, Paris 7 Diderot University, Department of Pharmacology, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Julie Delyon
- AP-HP Dermatology, hôpital Saint-Louis, Paris 7 Diderot University, Department of Dermatology, Inserm U976, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Céleste Lebbé
- AP-HP Dermatology, hôpital Saint-Louis, Paris 7 Diderot University, Department of Dermatology, Inserm U976, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Patel P, Modi C, McLellan B, Ohri N. Radiotherapy for inoperable Merkel cell carcinoma: a systematic review and pooled analysis. Dermatol Pract Concept 2018; 8:149-157. [PMID: 29785334 PMCID: PMC5955084 DOI: 10.5826/dpc.0802a15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 03/02/2018] [Indexed: 12/26/2022] Open
Abstract
Background Cumulative data on radiation monotherapy for Merkel cell carcinoma (MCC) is lacking. Objective We sought to synthesize all available data on treatment outcomes for radiation monotherapy for inoperable stage I-III MCC. Methods We performed a systematic review of the current literature. Articles published in English in the PubMed database up to July 29, 2016, were evaluated. Results Eight case reports, 4 case series, and 6 retrospective studies, yielding 68 patients, were included in our analysis. Of the 24 stage I/II patients treated with local irradiation, 6 (25%) relapsed and 1 (4%) died from MCC. Of the 24 stage I/II patients treated with local and regional nodal irradiation, 5 (21%) relapsed and 2 (8%) died from MCC. Of the 20 stage III patients treated with local and regional nodal irradiation, 12 (60%) relapsed and 7 (35%) died from MCC. Conclusions Radiation monotherapy appears to be a reasonable treatment modality for patients with inoperable stage I-III MCC. Further investigation with prospective studies is needed to draw definitive conclusions.
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Affiliation(s)
- Parth Patel
- Department of Medicine, Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Chirag Modi
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Beth McLellan
- Department of Medicine, Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Nitin Ohri
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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Abstract
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin associated with a high risk of local recurrence and distant metastases. It most commonly occurs on sun-exposed areas of white patients >65 years of age. The Merkel cell polyomavirus (MCV) is thought to be responsible for malignant transformation in approximately 80% of cases in the northern hemisphere, while ultraviolet radiation-induced DNA damage is implicated in MCV-negative tumors. The overall incidence of MCC is low, with approximately 1600 cases diagnosed annually in the United States. The rate is much higher in patients with lymphoproliferative malignancies, solid organ transplants, and HIV infection. The low overall incidence of this tumor makes it challenging to conduct prospective clinical trials with sufficient power. As a result, most management recommendations are based on case series, retrospective reviews, and expert opinion. The pathogenesis, diagnosis, and staging of MCC was discussed in the first article in this continuing medical education series. This article focuses on current management guidelines and promising new therapies in development. Because of the complexity, aggressive nature, and individuality of each case, MCC is best treated by a multidisciplinary team.
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