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Zhao M, Wang L, Wang X, He J, Yu K, Li D. Non-neoplastic cells as prognostic biomarkers in diffuse large B-cell lymphoma: A system review and meta-analysis. Tumori 2024:3008916231221636. [PMID: 38183180 DOI: 10.1177/03008916231221636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
The microenvironment of diffuse large B-cell lymphoma (DLBCL) is composed of various components, including immune cells and immune checkpoints, some of which have been correlated with the prognosis of DLBCL, but their results remain controversial. Therefore, we conducted a systematic review and meta-analysis to investigate the association between the microenvironment and prognosis in DLBCL. We searched PubMed, Web of Science, and EMBASE for relevant articles between 2001 and 2022. Twenty-five studies involving 4495 patients with DLBCL were included in the analysis. This meta-analysis confirmed that high densities of Foxp3+Tregs and PD-1+T cells are good indicators for overall survival (OS) in DLBCL, while high densities of programmed cell death protein ligand1(PD-L1)-positive expression cells and T-cell immunoglobulin-and mucin domain-3-containing molecule 3 (TIM-3)-positive expression tumor-infiltrating cells (TILs) play a contrary role in OS. Additionally, higher numbers of T-cell intracytoplasmic antigen-1(TIA-1)-positive expression T cells imply better OS and progression-free survival (PFS), while high numbers of lymphocyte activation gene(LAG)-positive expression TILs predict bad OS and PFS. Various non-tumoral cells in the microenvironment play important roles in the prognosis of DLBCL.
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Affiliation(s)
- Min Zhao
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Pathology, Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
| | - Lixing Wang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Xingyu Wang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Juan He
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Kuai Yu
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
- Department of Pathology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Li
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Pathology, Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
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Laurent C, Flores M, Chartier L, Huet S, Bolen CR, Venstrom JM, Chassagne-Clément C, Dartigues-Cuilléres P, Charlotte F, Tesson B, Salles G, Morschhauser F, Xerri L. Long-term follow-up confirms the favourable prognostic impact of high numbers of tumour infiltrating CD3 T-cells in follicular lymphoma patients treated by rituximab-maintenance regimen. Br J Haematol 2023; 202:686-689. [PMID: 37218065 PMCID: PMC10755216 DOI: 10.1111/bjh.18881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/09/2023] [Accepted: 05/13/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Camille Laurent
- Institut Universitaire Cancer-Oncopole, CHU Toulouse, INSERM U1037, Toulouse, France
| | | | | | - Sarah Huet
- Hospices Civils De Lyon, Pierre Bénite, France
| | | | | | | | | | | | | | - Gilles Salles
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Luc Xerri
- Institut Paoli-Calmettes, CRCM and Aix-Marseille University, Marseille, France
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Gao F, Zhang T, Liu H, Li W, Liu X, Qiu L, Li L, Zhou S, Qian Z, Dong S, Zhao S, Wang X, Zhang H. Risk factors for POD24 in patients with previously untreated follicular lymphoma: a systematic review and meta-analysis. Ann Hematol 2022; 101:2383-2392. [PMID: 36029326 DOI: 10.1007/s00277-022-04914-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
Abstract
Progression of disease within 24 months (POD24) is strongly associated with a poor outcome in patients with follicular lymphoma (FL). Our study aimed to identify the potential risk factors for POD24 in patients with FL. Medline, EMBASE and the Cochrane Library were systematically searched from the earliest record to September 2020. Studies investigating the prognostic factors for POD24 in patients with newly diagnosed grade 1-3a FL were included. Among 10,014 pieces of literature, a total of 90 studies investigating 82 risk factors were included for qualitative analysis. Meta-analyses were performed in 31 studies with 11 factors. Results showed that elevated sIL-2R, β2m and LDH, total metabolic tumour volume > 510 cm3, vitamin D < 20 ng/mL, grade 3a and lymphoma-associated macrophages/high-power field ≥ 15 were significantly associated with an increased risk of POD24. No significant association was found between POD24 and the ALC/AMC ratio, sex, T effector signature or EZH2 genetic alteration. Additionally, minimal residual disease, Ki-67, PD-1 and TP53 were analysed narratively. Overall, this is the first study that comprehensively analysed the prognostic factors associated with POD24 in FL patients. We have confirmed the significance value of several common prognostic factors as well as others not commonly included in clinical study, helping to construct an integrated and more efficient model.
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Affiliation(s)
- Fenghua Gao
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Tingting Zhang
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Hengqi Liu
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Wei Li
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Xianming Liu
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Lihua Qiu
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Lanfang Li
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Shiyong Zhou
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Zhengzi Qian
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China
| | - Sitong Dong
- Systematic Review Solutions Ltd, The Ingenuity Centre, Nottingham, UK
| | - Sai Zhao
- Systematic Review Solutions Ltd, The Ingenuity Centre, Nottingham, UK
| | - Xianhuo Wang
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China.
| | - Huilai Zhang
- Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China.
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Ménard C, Rossille D, Dulong J, Nguyen TT, Papa I, Latour M, Bescher N, Bezier I, Chouteau M, Fest T, Houot R, Morschhauser F, Tarte K. Lenalidomide triggers T-cell effector functions in vivo in patients with follicular lymphoma. Blood Adv 2021; 5:2063-74. [PMID: 33877296 DOI: 10.1182/bloodadvances.2020003774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/08/2021] [Indexed: 02/08/2023] Open
Abstract
The immunomodulatory drug lenalidomide is used in patients with follicular lymphoma (FL) with the aim of stimulating T-cell antitumor immune response. However, little is known about the effects of lenalidomide on T-cell biology in vivo in patients with FL. We thus undertook an extensive longitudinal immunologic study, including phenotypic, transcriptomic, and functional analyses, on 44 first-line and 27 relapsed/refractory patients enrolled in the GALEN trial (Obinutuzumab Combined With Lenalidomide for Relapsed or Refractory Follicular B-Cell Lymphoma) to test the efficacy of lenalidomide and obinutuzumab combination in patients with FL. Lenalidomide rapidly and transiently induced an activated T-cell phenotype, including HLA-DR, Tim-3, CD137, and programmed cell death protein 1 (PD-1) upregulation. Furthermore, sequential RNA-sequencing of sorted PD-1+ and PD-1- T-cell subsets revealed that lenalidomide triggered a strong enrichment for several gene signatures related to effector memory T-cell features, including proliferation, antigen receptor signaling, and immune synapse restoration; all were validated at the phenotypic level and with ex vivo functional assays. Correlative analyses pinpointed a negative clinical impact of high effector T-cell and regulatory T-cell percentages before and during treatment. Our findings bring new insight in lenalidomide mechanisms of action at work in vivo and will fuel a new rationale for the design of combination therapies.
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Tsakiroglou AM, Astley S, Dave M, Fergie M, Harkness E, Rosenberg A, Sperrin M, West C, Byers R, Linton K. Immune infiltrate diversity confers a good prognosis in follicular lymphoma. Cancer Immunol Immunother 2021. [PMID: 33929583 DOI: 10.1007/s00262-021-02945-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/14/2021] [Indexed: 11/29/2022]
Abstract
Background Follicular lymphoma (FL) prognosis is influenced by the composition of the tumour microenvironment. We tested an automated approach to quantitatively assess the phenotypic and spatial immune infiltrate diversity as a prognostic biomarker for FL patients. Methods Diagnostic biopsies were collected from 127 FL patients initially treated with rituximab-based therapy (52%), radiotherapy (28%), or active surveillance (20%). Tissue microarrays were constructed and stained using multiplex immunofluorescence (CD4, CD8, FOXP3, CD21, PD-1, CD68, and DAPI). Subsequently, sections underwent automated cell scoring and analysis of spatial interactions, defined as cells co-occurring within 30 μm. Shannon’s entropy, a metric describing species biodiversity in ecological habitats, was applied to quantify immune infiltrate diversity of cell types and spatial interactions. Immune infiltrate diversity indices were tested in multivariable Cox regression and Kaplan–Meier analysis for overall (OS) and progression-free survival (PFS). Results Increased diversity of cell types (HR = 0.19 95% CI 0.06–0.65, p = 0.008) and cell spatial interactions (HR = 0.39, 95% CI 0.20–0.75, p = 0.005) was associated with favourable OS, independent of the Follicular Lymphoma International Prognostic Index. In the rituximab-treated subset, the favourable trend between diversity and PFS did not reach statistical significance. Conclusion Multiplex immunofluorescence and Shannon’s entropy can objectively quantify immune infiltrate diversity and generate prognostic information in FL. This automated approach warrants validation in additional FL cohorts, and its applicability as a pre-treatment biomarker to identify high-risk patients should be further explored. The multiplex image dataset generated by this study is shared publicly to encourage further research on the FL microenvironment. Supplementary Information The online version contains supplementary material available at 10.1007/s00262-021-02945-0.
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Rossi C, Tosolini M, Gravelle P, Pericart S, Kanoun S, Evrard S, Gilhodes J, Franchini DM, Amara N, Syrykh C, Bories P, Oberic L, Ysebaert L, Martin L, Ramla S, Robert P, Tabouret-Viaud C, Casasnovas RO, Fournié JJ, Bezombes C, Laurent C. Baseline SUVmax is related to tumor cell proliferation and patient outcome in follicular lymphoma. Haematologica 2020; 107:221-230. [PMID: 33327711 PMCID: PMC8719066 DOI: 10.3324/haematol.2020.263194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 11/09/2022] Open
Abstract
Follicular lymphoma (FL) is the most common indolent lymphoma. Despite the clear benefit of CD20-based therapy, a subset of FL patients still progress to aggressive lymphoma. Thus, identifying early biomarkers that incorporate PET metrics could be helpful to identify patients with a high risk of treatment failure with Rituximab. We retrospectively included a total of 132 untreated FL patients separated into training and validation cohorts. Optimal threshold of baseline SUVmax was first determined in the training cohort (n=48) to predict progression-free survival (PFS). The PET results were investigated along with the tumor and immune microenvironment, which were determined by immunochemistry and transcriptome studies involving gene set enrichment analyses and immune cell deconvolution, together with the tumor mutation profile. We report that baseline SUVmax >14.5 was associated with poorer PFS than baseline SUVmax ≤14.5 (HR=0.28; p=0.00046). Neither immune T-cell infiltration nor immune checkpoint expression were associated with baseline PET metrics. By contrast, FL samples with Ki-67 staining ≥10% showed enrichment of cell cycle/DNA genes (p=0.013) and significantly higher SUVmax values (p=0.007). Despite similar oncogenic pathway alterations in both SUVmax groups of FL samples, 4 out of 5 cases harboring the infrequent FOXO1 transcription factor mutation were seen in FL patients with SUVmax >14.5. Thus, high baseline SUVmax reflects FL tumor proliferation and, together with Ki-67 proliferative index, can be used to identify patients at risk of early relapse with R-chemotherapy.
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Affiliation(s)
- Cédric Rossi
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; CHU Dijon, Hématologie clinique, Hôpital François Mitterrand, Dijon.
| | - Marie Tosolini
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse, France; Pôle Technologique du Centre de Recherches en Cancérologie de Toulouse, Toulouse
| | - Pauline Gravelle
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Sarah Pericart
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Salim Kanoun
- Médecine Nucléaire, Institut universitaire du cancer Toulouse-Oncopole, Toulouse
| | - Solene Evrard
- Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Julia Gilhodes
- Bureau des essais cliniques, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse
| | - Don-Marc Franchini
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite
| | - Nadia Amara
- Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Charlotte Syrykh
- Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse, France; Réseau Régional de Cancérologie, Onco-Occitanie, Institut Universitaire du Cancer Toulouse-Oncopole; Service d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Pierre Bories
- Réseau Régional de Cancérologie, Onco-Occitanie, Institut Universitaire du Cancer Toulouse-Oncopole; Service d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Lucie Oberic
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Loïc Ysebaert
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France.; Service d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse
| | - Laurent Martin
- Département de pathologie, CHU Hôpital François Mitterrand, Dijon, France; INSERM UMR 1231 UFR Bourgogne
| | - Selim Ramla
- Département de pathologie, CHU Hôpital François Mitterrand, Dijon, France; INSERM UMR 1231 UFR Bourgogne
| | - Philippine Robert
- CHU Dijon, Hématologie clinique, Hôpital François Mitterrand, Dijon, France; INSERM UMR 1231 UFR Bourgogne
| | | | - René-Olivier Casasnovas
- CHU Dijon, Hématologie clinique, Hôpital François Mitterrand, Dijon, France; INSERM UMR 1231 UFR Bourgogne
| | - Jean-Jacques Fournié
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite
| | - Christine Bezombes
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite.
| | - Camille Laurent
- Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR1037 INSERM, Université Toulouse III: Paul-Sabatier, ERL5294 CNRS, Université de Toulouse, Toulouse, France; Laboratoire d'Excellence TOUCAN, Toulouse, France; Programme Hospitalo-Universitaire en Cancérologie CAPTOR, Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Département de pathologie, Institut Universitaire du Cancer de Toulouse, Toulouse.
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Sorigue M, Cañamero E, Sancho JM. Precision medicine in follicular lymphoma: Focus on predictive biomarkers. Hematol Oncol 2020; 38:625-639. [PMID: 32700331 DOI: 10.1002/hon.2781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
Abstract
Current care for patients with follicular lymphoma (FL) offers most of them long-term survival. Improving it further will require careful patient selection. This review focuses on predictive biomarkers (ie, those whose outcome correlations depend on the treatment strategy) in FL, because awareness of what patient subsets benefit most or least from each therapy will help in this task. The first part of this review aims to summarize what biomarkers are predictive in FL, the magnitude of the effect and the quality of the evidence. We find predictive biomarkers in the setting of (a) indication of active treatment, (b) front-line induction (use of anthracyline-based regimens, CHOP vs bendamustine, addition of rituximab), (c) post-(front-line)induction (rituximab maintenance, radioimmunotherapy), and (d) relapse (hematopoietic stem cell transplant) and targeted agents. The second part of this review discusses the challenges of precision medicine in FL, including (a) cost, (b) clinical relevance considerations, and (c) difficulties over the broad implementation of biomarkers. We then provide our view on what biomarkers may become used in the next few years. We conclude by underscoring the importance of assessing the potential predictiveness of available biomarkers to improve patient care but also that there is a long road ahead before reaching their broad implementation due to remaining scientific, technological, and economic hurdles.
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Eloi Cañamero
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
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8
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Szumera-Ciećkiewicz A, Poleszczuk J, Kuczkiewicz-Siemion O, Paszkiewicz-Kozik E, Rymkiewicz G, Sokół K, Borysiuk A, Kotarska M, Kawecka M, Owczarek D, Pytlak B, Walewski J, Prochorec-Sobieszek M. PD1 distribution pattern, regardless of the cell origin, is an independent microenvironmental prognostic factor for progression-free survival in follicular lymphoma. Pathol Res Pract 2020; 216:153096. [PMID: 32853965 DOI: 10.1016/j.prp.2020.153096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023]
Abstract
Follicular lymphoma (FL) is a well-studied microenvironment-dependent hematological malignancy, but the crosstalk between various involved cell subtypes is still not fully understood. Recent promising results of immunotherapy in recurrent FL warrant the need for an in-depth analysis of the expression and role of immune system-related proteins in the FL microenvironment. Seventy-one patients with FL and available diagnostic paraffin blocks were enrolled in the retrospective analysis. Histopathological diagnoses were revised according to the World Health Organization recommendations. Patients were either observed (watch and wait/W&W group) or immediately treated with chemo(immuno)therapy regimens according to their clinical status. Immunohistochemical assessment of PD1, PDL1, CD4, CD8, CD163, CD68-KP1, CD68-PGM1 was performed. The scoring methods included both semi-quantitative estimation of positive cells and architectural pattern distribution. The differences between PD1 staining distribution and intensity were classified as intra/perifollicular vs. interfollicular/diffuse cells and presented bright vs. dim immunoreactivity, respectively. No statistically significant differences in the density distribution of the immunohistochemical stainings were found between W&W and chemo(immuno)therapy groups. Interfollicular/diffuse pattern of PD1 expression had significantly decreased progression-free survival when analyzing the whole cohort and patients on chemo(immuno)therapy (p = 0.014 and p = 0.07, respectively). The high dependence was not significant in the W&W group. PD1 positivity of cells did not correlate with CD4 or CD8 immunophenotype. Morphologically FL neoplastic cells were entirely PDL1 negative, but granular and membranous staining was detected in the FL microenvironment. In line with previous studies, PD1/PDL1 expression was predominantly localized in the FL microenvironment, indicating that FL cells might not be the direct target for anti-PDL1 therapy. However, we show that the localization of PD1 expression could be a viable progression-free survival biomarker for FL.
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Affiliation(s)
- Anna Szumera-Ciećkiewicz
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
| | - Jan Poleszczuk
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Poland; Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Olga Kuczkiewicz-Siemion
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Grzegorz Rymkiewicz
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Flow Cytometry Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Kamil Sokół
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Anita Borysiuk
- Flow Cytometry Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Martyna Kotarska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Monika Kawecka
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Daria Owczarek
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Beata Pytlak
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Monika Prochorec-Sobieszek
- Pathology Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
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9
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Abstract
New treatment strategies in follicular lymphoma (FL) are driven by a deeper understanding of microenvironmental cues supporting lymphomagenesis, chemoresistance, and immuno-escape. These immune-mediated signaling pathways contribute to initial learnings and clinical successes with lenalidomide, the first, oral, non-chemotherapeutic immunomodulatory drug, combined with anti-CD20 antibodies. This combination of lenalidomide with rituximab showed similar efficacy to chemoimmunotherapy (CIT) in first-line patients requiring therapy, and is approved in relapsed/refractory FL. We review the biology supporting the rationale for adequate inhibitory receptor/ligand pathways targeting the tissue immune microenvironment of FL cells, and potential immunomodulating combinations to replace CIT in the near future.
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Affiliation(s)
- Loic Ysebaert
- Service d'Hematologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Center for Cancer Research of Toulouse (CRCT), Inserm UMR1037, IUC-Toulouse-Oncopole, 1 Avenue Irene Joliot-Curie, Toulouse 31059, France
| | - Franck Morschhauser
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche Sur les Formes Injectables et les Technologies Associees, Lille F-59000, France.
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10
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Gopal AK, Levy R, Houot R, Patel SP, Popplewell L, Jacobson C, Mu XJ, Deng S, Ching KA, Chen Y, Davis CB, Huang B, Fly KD, Thall A, Woolfson A, Bartlett NL. First-in-Human Study of Utomilumab, a 4-1BB/CD137 Agonist, in Combination with Rituximab in Patients with Follicular and Other CD20 + Non-Hodgkin Lymphomas. Clin Cancer Res 2020; 26:2524-2534. [PMID: 32144134 DOI: 10.1158/1078-0432.ccr-19-2973] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE In this phase I study (NCT01307267), we evaluated safety, pharmacokinetics, clinical activity, and pharmacodynamics of treatment with utomilumab plus rituximab in patients with relapsed/refractory follicular lymphoma (FL) and other CD20+ non-Hodgkin lymphomas (NHL). PATIENTS AND METHODS Primary objectives were to assess treatment safety and tolerability for estimating the MTD, using a modified time-to-event continual reassessment method, and selecting the recommended phase II dose (RP2D). RESULTS Sixty-seven patients received utomilumab (0.03-10.0 mg/kg every 4 weeks) and rituximab (375 mg/m2 weekly) in the dose-escalation groups or utomilumab (1.2 mg/kg every 4 weeks) plus rituximab in the dose-expansion cohort. No patient experienced dose-limiting toxicity. The MTD for utomilumab in combination with rituximab was not reached and estimated to be ≥10 mg/kg every 4 weeks. The majority of the utomilumab treatment-related adverse events (AE) were grade 1 to 2; the most common AE was fatigue (16.4%). The pharmacokinetics of utomilumab in combination with rituximab was linear in the 0.03 to 10 mg/kg dose range. A low incidence (1.5%) of treatment-induced antidrug antibodies against utomilumab was observed. The objective response rate was 21.2% (95% CI, 12.1%-33.0%) in all patients with NHL, including four complete and 10 partial responses. Analysis of paired biopsies from a relapsed/refractory FL patient with complete response showed increased T-cell infiltration and cytotoxic activity in tumors. Biomarker correlations with outcomes suggested that clinical benefit may be contingent on patient immune function. CONCLUSIONS Utomilumab in combination with rituximab demonstrated clinical activity and a favorable safety profile in patients with CD20+ NHLs.
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Affiliation(s)
- Ajay K Gopal
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, Washington.
| | - Ronald Levy
- Stanford Cancer Center, Stanford, California
| | - Roch Houot
- 1 CHU Rennes, Service Hématologie Clinique Rennes, France.,University of Rennes, EFS, Microenvironment, Cell Differentiation, Immunology and Cancer Rennes, France.,INSERM 0203, Unité d'Investigation Clinique, Rennes, France
| | - Sandip P Patel
- University of California at San Diego Moores Cancer Center, San Diego, California
| | | | | | | | | | | | - Ying Chen
- Pfizer Oncology, San Diego, California
| | | | - Bo Huang
- Pfizer Oncology, Groton, Connecticut
| | | | | | | | - Nancy L Bartlett
- Washington University School of Medicine, Siteman Cancer Center, St Louis, Missouri
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11
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Menter T, Tzankov A, Zucca E, Kimby E, Hultdin M, Sundström C, Beiske K, Cogliatti S, Banz Y, Cathomas G, Karjalainen-Lindsberg ML, Grobholz R, Mazzucchelli L, Sander B, Hawle H, Hayoz S, Dirnhofer S. Prognostic implications of the microenvironment for follicular lymphoma under immunomodulation therapy. Br J Haematol 2020; 189:707-717. [PMID: 32012230 DOI: 10.1111/bjh.16414] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 12/24/2022]
Abstract
Follicular lymphoma (FL) constitutes a significant proportion of lymphomas and shows frequent relapses. Beyond conventional chemotherapy, new therapeutic approaches have emerged, focussing on the interplay between lymphoma cells and the microenvironment. Here we report the immunophenotypic investigation of the microenvironment of a clinically well-characterized prospective cohort (study SAKK35/10, NCT01307605) of 154 treatment-naïve FL patients in need of therapy, who have been treated with rituximab only or a combination of rituximab and the immunomodulatory drug lenalidomide/Revlimid® A high ratio of CD4- to CD8-positive T cells (P = 0·009) and increased amounts of PD1+ tumour-infiltrating T cells (P = 0·007) were associated with inferior progression-free survival in the whole cohort. Interestingly, the prognostic impact of PD1+ T cells and the CD4/CD8 ratio lost its significance in the subgroup treated with R2 . In the latter group, high amounts of GATA3+ T helper (Th2) equivalents were associated with better progression-free survival (P < 0·001). We identified tumour microenvironmental features that allow prognostic stratification with respect to immuno- and combined immuno- and immunomodulatory therapy. Our analysis indicates that lenalidomide may compensate the adverse prognostic implication of higher amounts of CD4+ and, particularly, PD1+ T cells and that it has favourable effects mainly in cases with higher amounts of Th2 equivalents. [Correction added on 11 February 2020, after online publication: The NCT-trial number was previously incorrect and has been updated in this version].
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Affiliation(s)
- Thomas Menter
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Emanuele Zucca
- Division of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Institute of Oncology Research, Bellinzona, Switzerland.,Department of Medical Oncology, Inselspital / Bern University Hospital, Bern, Switzerland
| | - Eva Kimby
- Division of Hematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Hultdin
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | | | - Klaus Beiske
- Department of Pathology, Oslo University Hospital, and Institute of Clinical Medicine, The Medical Faculty, University of Oslo, Oslo, Norway
| | - Sergio Cogliatti
- Institute of Pathology, Cantonal Hospital, St. Gallen, Switzerland
| | - Yara Banz
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Gieri Cathomas
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | | | - Rainer Grobholz
- Institute of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland
| | | | - Birgitta Sander
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet and Karolinska University, Stockholm, Sweden
| | | | | | - Stefan Dirnhofer
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
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12
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Milcent B, Josseaume N, Petitprez F, Riller Q, Amorim S, Loiseau P, Toubert A, Brice P, Thieblemont C, Teillaud JL, Sibéril S. Recovery of central memory and naive peripheral T cells in Follicular Lymphoma patients receiving rituximab-chemotherapy based regimen. Sci Rep 2019; 9:13471. [PMID: 31530876 PMCID: PMC6748924 DOI: 10.1038/s41598-019-50029-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/04/2019] [Indexed: 02/08/2023] Open
Abstract
Preclinical models and clinical studies have shown that anti-CD20-based treatment has multifaceted consequences on T-cell immunity. We have performed a prospective study of peripheral T-cell compartment in FL patients, all exhibiting high tumor burden and receiving rituximab-chemotherapy-based regimen (R-CHOP). Before treatment, FL patients harbor low amounts of peripheral naive T cells, but high levels of CD4+ TEM, CD4+ Treg and CD8+ TEMRA subsets and significant amounts of CD38+ HLA-DR+ activated T cells. A portion of these activated/differentiated T cells also expressed PD-1 and/or TIGIT immune checkpoints. Hierarchical clustering of phenotyping data revealed that 5/8 patients with only a partial response to R-CHOP induction therapy or with disease progression segregate into a group exhibiting a highly activated/differentiated T cell profile and a markedly low proportion of naive T cells before treatment. Rituximab-based therapy induced a shift of CD4+ and CD8+ T cells toward a central memory phenotype and of CD8+ T cells to a naive phenotype. In parallel, a decrease in the number of peripheral T cells expressing both PD-1 and TIGIT was detected. These observations suggest that the standard rituximab-based therapy partially reverts the profound alterations observed in T-cell subsets in FL patients, and that blood T-cell phenotyping could provide a better understanding of the mechanisms of rituximab-based treatment.
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Affiliation(s)
- B Milcent
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France.,Sorbonne Université, UMR-S 1138, Paris, 75006, France.,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France
| | - N Josseaume
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France.,Sorbonne Université, UMR-S 1138, Paris, 75006, France.,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France
| | - F Petitprez
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France.,Sorbonne Université, UMR-S 1138, Paris, 75006, France.,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France.,Ligue Nationale Contre le Cancer, Programme Cartes d'Identité des Tumeurs, Paris, 75014, France
| | - Q Riller
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France.,Sorbonne Université, UMR-S 1138, Paris, 75006, France.,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France
| | - S Amorim
- APHP, Saint-Louis Hospital, Hemato-oncology - Diderot University, Sorbonne Paris Cité, Paris, France
| | - P Loiseau
- Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,Inserm UMR-S 1160, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, 7, France
| | - A Toubert
- Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,Inserm UMR-S 1160, Paris, France.,Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, 7, France
| | - P Brice
- APHP, Saint-Louis Hospital, Hemato-oncology - Diderot University, Sorbonne Paris Cité, Paris, France
| | - C Thieblemont
- APHP, Saint-Louis Hospital, Hemato-oncology - Diderot University, Sorbonne Paris Cité, Paris, France.,EA7324 Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - J-L Teillaud
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France.,Sorbonne Université, UMR-S 1138, Paris, 75006, France.,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France.,Laboratory "Immune Microenvironment and Biotherapy", Sorbonne University UMRS1135, INSERM U.1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI), Paris, France
| | - S Sibéril
- Cordeliers Research Center-Inserm UMR-S 1138, "Cancer, Immune Control and Escape" Laboratory, Paris, 75006, France. .,Sorbonne Université, UMR-S 1138, Paris, 75006, France. .,Paris Descartes-Paris 5 University, UMR-S 1138, Paris, 75006, France.
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13
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Budau L, Wilhelm C, Moll R, Jäkel J, Hirt C, Dölken G, Maschmeyer G, Neubauer E, Strauch K, Burchert A, Herold M, Neubauer A. Low number of intrafollicular T cells may predict favourable response to rituximab-based immuno-chemotherapy in advanced follicular lymphoma: a secondary analysis of a randomized clinical trial. J Cancer Res Clin Oncol 2019; 145:2149-2156. [PMID: 31273513 PMCID: PMC6658576 DOI: 10.1007/s00432-019-02961-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/22/2019] [Indexed: 12/24/2022]
Abstract
Background First-line rituximab therapy together with chemotherapy is the standard care for patients with advanced follicular B-cell lymphoma, as rituximab together with chemotherapy prolongs progression-free and overall survival (Herold et al. 2007; Marcus et al. 2005). However, as not all patient subgroups benefit from combined immuno-chemotherapy, we asked whether the microenvironment may predict benefit from rituximab-based therapy. Design To address this question, we performed a retrospective immunohistochemical analysis on pathological specimens of 18 patients recruited into a randomized clinical trial, where patients with advanced follicular lymphoma were randomized into either chemotherapy or immuno-chemotherapy with rituximab (Herold et al. 2007). Results We show here that rituximab exerts beneficial effects, especially in the subgroup of follicular lymphoma patients with low intrafollicular CD3, CD5, CD8, and ZAP70 and high CD56 and CD68 expression. Conclusion Rituximab may overcome immune-dormancy in follicular lymphoma in cases with lower intrafollicular T-cell numbers and higher CD56 and CD68 cell counts. As this was a retrospective analysis on a small subgroup of patients, these data need to be corroborated in larger clinical trials. Electronic supplementary material The online version of this article (10.1007/s00432-019-02961-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Budau
- Klinik für Hämatologie Onkologie, Immunologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany.,, Kath. Marienkrankenhaus, gynäkologie Alfredstraße 9, 22087, Hamburg, Germany
| | - Christian Wilhelm
- Klinik für Hämatologie Onkologie, Immunologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany
| | - Roland Moll
- Institut für Pathologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany
| | - Jörg Jäkel
- Institut für Pathologie, Universitätsklinik der RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Carsten Hirt
- Klinik und Poliklinik für Innere Medizin Hämatologie und Onkologie, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
| | - Gottfried Dölken
- Klinik und Poliklinik für Innere Medizin Hämatologie und Onkologie, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
| | - Georg Maschmeyer
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Ernst von Bergmann gemeinnützige GmbH, Charlottenstraße 72, 14467, Potsdam, Germany
| | - Ellen Neubauer
- Klinik für Gynäkologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany
| | - Konstantin Strauch
- Institut für Genetische Epidemiologie, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.,Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie Faculty of Medicine, LMU Munich, Marchioninistraße 15, 81377, München, Germany
| | - Andreas Burchert
- Klinik für Hämatologie Onkologie, Immunologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany
| | - Michael Herold
- Onkologisches Zentrum, Helios-Klinikum Erfurt, Nordhäuserstr. 74, 99089, Erfurt, Germany
| | - Andreas Neubauer
- Klinik für Hämatologie Onkologie, Immunologie, Philipps Universität Marburg, und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Germany.
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14
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Kobata K, Mihashi Y, Nonaka S, Matsumoto S, Kawauchi S, Iwasaki H, Takamatsu Y, Takeshita M. Cytological tumour cell characteristics and reactive small lymphocytes influence patient prognosis in acute and lymphoma type adult T-cell leukaemia/lymphoma. Cytopathology 2019; 30:402-412. [PMID: 30907476 DOI: 10.1111/cyt.12693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/21/2019] [Accepted: 03/11/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Acute and lymphoma type adult T-cell leukaemia/lymphoma (ATLL) patients show an aggressive clinical course. While some clinical signs indicate good prognosis, definitive cytohistological prognostic factors have yet to be described. METHODS We classified 65 ATLL patients into three groups by tumour cell size and nuclear pleomorphism on fine-needle aspiration and tumour touch smear samples. Semi-quantitative analysis of background small lymphocytes, reactive CD20-positive B cells and CD8-positive T cells was performed. RESULTS Thirty-one patients had pleomorphic lymphoma with predominantly medium-sized cells and coarse granular nuclei. Another 24 patients showed pleomorphic large cell lymphoma with stippled chromatin. The remaining 10 demonstrated monomorphic large lymphoma cells with fine granular chromatin. Patients with pleomorphic lymphoma with medium-sized cells showed significantly higher serum lactate dehydrogenase and lower CD30 and C-MYC expression in lymphoma cells than the other two groups (P = .0216, P < 0.01, respectively). Patients with pleomorphic medium-sized ATLL had few usual small lymphocytes observed on routine morphological examination and showed less concurrent detection of CD20-positive B cells and CD8-positive T cells, both of which were lower than in the other two groups (P = .006, P = .019, respectively). Furthermore, ATLL patients with predominantly medium-sized lymphocytes exhibited a worse prognosis than patients with pleomorphic large cells (P = .0197). Background small lymphocytes and concurrent detection of CD20-positive B cells and CD8-positive T cells may thus be good prognostic factors (P = .011, P = .021, respectively). CONCLUSIONS Morphological features, size of neoplastic cells and background non-neoplastic lymphocyte (B cells and CD8-positive T cells) volume appear to influence the prognosis of patients with aggressive-type ATLL.
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Affiliation(s)
- Katsumi Kobata
- Pathology Laboratory, Fukuoka University Hospital, Fukuoka, Japan
| | - Yasuhito Mihashi
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.,Department of Otolaryngology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shuichi Nonaka
- Department of Pathology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Shinji Matsumoto
- Pathology Laboratory, Fukuoka University Hospital, Fukuoka, Japan
| | - Shigeto Kawauchi
- Department of Pathology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiroki Iwasaki
- Department of Hematology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Morishige Takeshita
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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15
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Delfau-Larue MH, van der Gucht A, Dupuis J, Jais JP, Nel I, Beldi-Ferchiou A, Hamdane S, Benmaad I, Laboure G, Verret B, Haioun C, Copie-Bergman C, Berriolo-Riedinger A, Robert P, Casasnovas RO, Itti E. Total metabolic tumor volume, circulating tumor cells, cell-free DNA: distinct prognostic value in follicular lymphoma. Blood Adv 2018; 2:807-16. [PMID: 29636326 DOI: 10.1182/bloodadvances.2017015164] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/13/2018] [Indexed: 12/17/2022] Open
Abstract
Outcomes for follicular lymphoma (FL) have greatly improved, but most patients will ultimately relapse. High total metabolic tumor volume (TMTV), computed from baseline 18F-fluorodeoxyglucose-positron emission tomography (PET), is associated with shorter progression-free survival (PFS), but circulating tumor cells (CTCs) and cell-free DNA (cfDNA) may also reflect tumor burden and be of prognostic value. The aim of our study was to correlate CTCs and cfDNA with TMTV in FL at diagnosis and to determine their prognostic values. We retrospectively analyzed 133 patients (with previously untreated FL and a baseline PET) from 2 cohorts with either a baseline plasma sample (n = 61) or a bcl2-JH-informative peripheral blood (PB) sample (n = 68). Quantification of circulating bcl2-JH+ cells and cfDNA was performed by droplet digital polymerase chain reaction. A significant correlation was found between TMTV and both CTCs (P < .0001) and cfDNA (P < .0001). With a median 48-month follow-up, 4-year PFS was lower in patients with TMTV > 510 cm3 (P = .0004), CTCs >0.0018 PB cells (P = .03), or cfDNA >2550 equivalent-genome/mL (P = .04). In comparison with TMTV alone, no additional prognostic information was obtained by measuring CTCs. In contrast, Cox multivariate analysis, including cfDNA and TMTV, showed that both cfDNA and TMTV remained predictive of outcome. In conclusion, CTCs and cfDNA correlate with TMTV in FL, and all 3 influence patient outcome. PFS was shorter for patients with high cfDNA and TMTV, suggesting that these parameters provide relevant information for tumor-tailored therapy.
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16
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Lansigan F, Barak I, Pitcher B, Jung SH, Cheson BD, Czuczman M, Martin P, Hsi E, Schöder H, Smith S, Bartlett NL, Leonard JP, Blum KA. The prognostic significance of PFS24 in follicular lymphoma following firstline immunotherapy: A combined analysis of 3 CALGB trials. Cancer Med 2018; 8:165-173. [PMID: 30575311 PMCID: PMC6346218 DOI: 10.1002/cam4.1918] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/02/2018] [Accepted: 11/19/2018] [Indexed: 12/22/2022] Open
Abstract
Follicular lymphoma (FL) patients treated with firstline R‐CHOP who experience progression of disease (POD) within 2 years have a shorter survival than those who do not have POD within 2 years. Whether this observation holds for patients treated initially with biologic immunotherapy alone is unknown. We performed a retrospective analysis of 174 patients pooled from three frontline rituximab (R)‐based nonchemotherapy doublet trials: R‐galiximab (Anti‐CD80, CALGB 50402), R‐epratuzumab (Anti‐CD22, CALGB 50701), and R‐lenalidomide (CALGB 50803) to determine outcomes of early progressors and risk factors for early POD, defined as progression within 24 months from study entry. Twenty‐eight percent (48/174) of patients had early POD. After adjusting for the Follicular Lymphoma International Prognostic Index (FLIPI), patients with early POD from study entry had a worse OS compared with patients who did not progress within 2 years (HR = 4.33 (95% CI 1.50‐12.5), P = 0.007). For early POD, the 2‐year survival was 80% vs 99% for nonearly POD, and the 5‐year survival was 74% vs 90%, respectively. These findings suggest that the adverse survival of patients with early POD may be independent of initial treatment modality.
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Affiliation(s)
| | - Ian Barak
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Brandelyn Pitcher
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Sin-Ho Jung
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Bruce D Cheson
- MedStar Georgetown University Hospital, Washington, District of Columbia
| | | | - Peter Martin
- Weill Medical College of Cornell University, New York, New York
| | - Eric Hsi
- Cleveland Clinic Foundation, Cleveland, Ohio
| | - Heiko Schöder
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Scott Smith
- Alliance Protocol Office, University of Chicago, Chicago, Illinois
| | | | - John P Leonard
- Weill Medical College of Cornell University, New York, New York
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17
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Shi Y, Deng L, Song Y, Lin D, Lai Y, Zhou L, Yang L, Li X. CD3+/CD8+ T-cell density and tumoral PD-L1 predict survival irrespective of rituximab treatment in Chinese diffuse large B-cell lymphoma patients. Int J Hematol 2018; 108:254-266. [DOI: 10.1007/s12185-018-2466-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 10/16/2022]
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18
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Xerri L, Huet S, Salles G. Tumor-infiltrating T lymphocytes and morphogenesis of follicular lymphoma-reply. Hum Pathol 2017; 72:198-199. [PMID: 29126835 DOI: 10.1016/j.humpath.2017.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/29/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Luc Xerri
- Department of Bio-Pathology and Tumor Immunology, Institut Paoli-Calmettes, Aix-Marseille University UM105, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068 CNRS UMR7258, 13009 Marseille, France.
| | - Sarah Huet
- INSERM1052, CNRS 5286, Centre de Recherche en Cancerologie de Lyon, Faculté de Médecine Lyon-Sud Charles Mérieux, Hospices Civils De Lyon, Laboratoire d'hématologie, 69495 Pierre Bénite, France
| | - Gilles Salles
- INSERM1052, CNRS 5286, Centre de Recherche en Cancerologie de Lyon, Faculté de Médecine Lyon-Sud Charles Mérieux, Hospices Civils De Lyon, Laboratoire d'hématologie, 69495 Pierre Bénite, France
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Bolen CR, McCord R, Huet S, Frampton GM, Bourgon R, Jardin F, Dartigues P, Punnoose EA, Szafer-Glusman E, Xerri L, Sujobert P, Salles G, Venstrom JM. Mutation load and an effector T-cell gene signature may distinguish immunologically distinct and clinically relevant lymphoma subsets. Blood Adv 2017; 1:1884-90. [PMID: 29296835 DOI: 10.1182/bloodadvances.2016000786] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 07/03/2017] [Indexed: 01/08/2023] Open
Abstract
Identifying follicular lymphoma (FL) patients with preexisting antitumor immunity will inform precision medicine strategies for novel cancer immunotherapies. Using clinical and genomic data from 249 FL patients, we determined the clinical impact of mutation load and an effector T-cell (Teff) gene signature as proxies for the likelihood of a functional immune response. The FL mutation load estimate varied between 0 and 33 mutations per Mb (median, 6.6), and 92% of FL patients with a high mutation load had high Teff gene expression (P = .001). The mutation load was associated with a benefit from rituximab maintenance: FL patients with low mutation loads experienced a profound benefit from rituximab maintenance (hazard ratio [HR], 0.29; 95% confidence interval [CI], 0.15-0.54; P < .001). The Teff gene signature was prognostic as a continuous predictor (P = .008), and was used to separate FL patients into 2 groups, an "inflamed" subset (Teff-high; n = 74) and an "uninflamed" subset (Teff-low; n = 75), with longer progression-free survival (PFS) in the inflamed FL subset (PFS HR, 0.39; 95% CI, 0.21-0.70; P = .002). Furthermore, the subset of inflamed FL tumors demonstrated high expression of other T-cell signatures and counterregulatory genes, which also correlate with PFS. Mutation load and Teff gene expression may help identify immunologically distinct lymphoma subsets relevant for modern immunotherapies.
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