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Almekinders MM, Bismeijer T, Kumar T, Yang F, Thijssen B, van der Linden R, van Rooijen C, Vonk S, Sun B, Parra Cuentas ER, Wistuba II, Krishnamurthy S, Visser LL, Seignette IM, Hofland I, Sanders J, Broeks A, Love JK, Menegaz B, Wessels L, Thompson AM, de Visser KE, Hooijberg E, Lips E, Futreal A, Wesseling J. Comprehensive multiplexed immune profiling of the ductal carcinoma in situ immune microenvironment regarding subsequent ipsilateral invasive breast cancer risk. Br J Cancer 2022; 127:1201-1213. [PMID: 35768550 PMCID: PMC9519539 DOI: 10.1038/s41416-022-01888-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/23/2021] [Revised: 05/17/2022] [Accepted: 06/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background Ductal carcinoma in situ (DCIS) is treated to prevent subsequent ipsilateral invasive breast cancer (iIBC). However, many DCIS lesions will never become invasive. To prevent overtreatment, we need to distinguish harmless from potentially hazardous DCIS. We investigated whether the immune microenvironment (IME) in DCIS correlates with transition to iIBC. Methods Patients were derived from a Dutch population-based cohort of 10,090 women with pure DCIS with a median follow-up time of 12 years. Density, composition and proximity to the closest DCIS cell of CD20+ B-cells, CD3+CD8+ T-cells, CD3+CD8− T-cells, CD3+FOXP3+ regulatory T-cells, CD68+ cells, and CD8+Ki67+ T-cells was assessed with multiplex immunofluorescence (mIF) with digital whole-slide analysis and compared between primary DCIS lesions of 77 women with subsequent iIBC (cases) and 64 without (controls). Results Higher stromal density of analysed immune cell subsets was significantly associated with higher grade, ER negativity, HER-2 positivity, Ki67 ≥ 14%, periductal fibrosis and comedonecrosis (P < 0.05). Density, composition and proximity to the closest DCIS cell of all analysed immune cell subsets did not differ between cases and controls. Conclusion IME features analysed by mIF in 141 patients from a well-annotated cohort of pure DCIS with long-term follow-up are no predictors of subsequent iIBC, but do correlate with other factors (grade, ER, HER2 status, Ki-67) known to be associated with invasive recurrences. ![]()
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Affiliation(s)
- Mathilde M Almekinders
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tycho Bismeijer
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tapsi Kumar
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA.,Department of Genetics, MD Anderson Cancer Center, Houston, TX, USA.,MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Fei Yang
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Bram Thijssen
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rianne van der Linden
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Charlotte van Rooijen
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Shiva Vonk
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Baohua Sun
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Edwin R Parra Cuentas
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Lindy L Visser
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Iris M Seignette
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ingrid Hofland
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Joyce Sanders
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Jason K Love
- Breast Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Brian Menegaz
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Lodewyk Wessels
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Oncode Institute, Utrecht, The Netherlands
| | | | - Karin E de Visser
- Oncode Institute, Utrecht, The Netherlands.,Division of Tumour Biology & Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik Hooijberg
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Esther Lips
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Futreal
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Jelle Wesseling
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands. .,Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. .,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
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Slagter M, Rozeman EA, Ding H, Versluis JM, Valenti M, Peters D, Broeks A, Rooijen CV, Horlings H, Haanen JBAG, Hooijberg E, Wessels LFA, Blank CU, Schumacher TN. Spatial proximity of CD8 T cells to tumor cells as an independent biomarker for response to anti-PD-1 therapy. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10038] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10038 Background: Only a subset of advanced melanoma patients respond to anti-PD-1 (aPD1) monotherapy. Upfront identification of (non-)responsiveness would help guide first-line treatment decisions, prevent overtreatment and unnecessary risk for toxicities. T cell density and expression of T cell related genes have been associated with response to aPD1, but are imperfect predictors. We investigated whether spatial proximity of CD8 T cells to tumor cells improves upon the predictive value of T cell density alone. Methods: Pretreatment tumor specimens from melanoma patients treated with aPD1 in the Netherlands Cancer Institute were stained for DAPI, SOX10/Melan-A, CD4, CD8, FOXP3 and PD-1 by multiplex immunofluorescence. Sections were imaged on Vectra and analyzed using HALO to optimize marker thresholds and demarcate tumor and stroma. T cell proximity to tumor cells was evaluated as difference in area under the curve between i) a spatial G-function quantifying T cell density around tumor cells in tumor areas and ii) analogous null distributions obtained by random permutation of cell labels. This assessment of co-clustering is independent of cell density and heterogeneity therein and does not reflect repulsion of T cells to stromal/marginal areas. Clinical characteristics, RECIST response and survival were collected from patient records. Associations between T cell density, T cell proximity to Sox10/Melan-A+ tumor cells, other clinical biomarkers (LDH, M stage and WHO performance status) and response were examined in a Bayesian hierarchical logistic regression. Results: Tumor specimens of 98 patients were included, of whom 45 were treated with aPD1 as first-line therapy and 33 had an objective response. CD8 T cell proximity to tumor cells was associated with response in an independent, comparatively strong, and tissue dependent manner (cutaneous tissue: 2.78 [2.45, 3.17], visceral: 2.30 [1.95, 2.72], lymphoid: 2.12 [1.88, 2.40], format: maximal posteriori odds ratio [89% equal-tailed credibility interval]), in a multivariate model correcting for CD8 T cell density (1.74 [1.62, 1.88]), LDH (1.93 [1.72, 2.16]), M stage (0.92 [0.87, 0.98]) and WHO performance status (0.79 [0.72, 0.88]). Our model achieved an area under the ROC curve of 77.7%, whereas an analogous model omitting the proximity variable achieved 73.1%. Conclusions: Our analyses show that spatial proximity of CD8 T cells to tumor cells functions as an independent biomarker for response to aPD1 and suggests that preexisting CD8 T cell tumor reactivity is reflected by this spatial proximity.
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Affiliation(s)
| | | | - Huiwen Ding
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Dennis Peters
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Hugo Horlings
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Lodewyk F. A. Wessels
- Department of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, Netherlands
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Almekinders MM, Visser L, Thijssen B, Linden RVD, Rooijen CV, Kristel P, Broeks A, Bismeijer T, Wessels L, Hooijberg E, Visser KD, Lips E, Wesseling J. Abstract 2806: Progression of ductal carcinoma in situ (DCIS), is it in the immune microenvironment. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: DCIS is a non-obligate precursor to invasive breast cancer (IBC). DCIS patients are treated similarly to breast cancer with surgery, often followed by radiotherapy and/or endocrine treatment. However, most DCIS lesions will never progress to IBC, indicating that overdiagnosis and overtreatment exists. DCIS lesions show variable amounts of immune cells, particularly in the periductal stroma. Immune escape might be a critical step for transition from DCIS to IBC. We aim to identify factors within the immune microenvironment of DCIS lesions that distinguish harmless from potentially hazardous DCIS.
Methods: A case-control study is being conducted consisting of women with pure DCIS diagnosed between 1989-2005 with median follow-up of 12 years, treated with breast conserving surgery only. Cases are defined as women with DCIS developing subsequent ipsilateral breast cancer (iIBC), controls as women with DCIS without subsequent iIBC. Multispectral immunohistochemical imaging was performed on primary DCIS lesions, aiming at detection of CD20+ B-cells, CD8+ T-cells, CD3+ T-cells, CD3+Foxp3+ regulatory T-cells, and CD68+ macrophages. Density of immune cell subsets in cells/mm2, immune cell ratios and spatial relationships were calculated for 27 cases and 28 controls. These immune cell related factors were correlated to outcome and integrated with RNAseq data of pure microdissected DCIS. We performed gene set enrichment analysis on the correlation between DCIS gene expression and density of immune cell types with sample permutation (flexgsea R package).
Results: Stromal lymphocyte, B-cell, CD8+ T-cell, regulatory T-cell and macrophage density did not significantly differ between cases and controls. Immune cell composition (CD8+ T-cell/lymphocyte, CD8+ T-cell/CD3+Foxp3+ regulatory T-cell and CD20+/lymphocyte ratio) and fraction of regulatory T-cells in close proximity of a CD8+ T-cell did not differ between cases and controls. We find a negative association between stromal B-cell density and DCIS gene expression of estrogen receptor (ESR1) targets. Higher stromal T-cell density was associated with proliferation and expression of genes characteristic for luminal B and basal-like subtypes. Furthermore, higher density of specific immune cell subsets within the DCIS compartment was associated with several immune and cancer pathways.
Conclusion: A first set of analyzed DCIS cases (n=27) and controls (n=28) show no significant differences regarding immune cell density, composition and spatial relationships. Considering the entire group of DCIS patients (n=55), a negative association between stromal B-cell density and gene expression of ESR1 targets was found. Higher density of lymphocytes was associated with proliferation and expression of genes characteristic for luminal B and basal-like subtypes. The full set of 175 DCIS lesions will be presented at AACR Annual Meeting 2019.
Citation Format: Mathilde M. Almekinders, Lindy Visser, Bram Thijssen, Rianne van der Linden, Charlotte van Rooijen, Petra Kristel, Annegien Broeks, Tycho Bismeijer, Lodewyk Wessels, Erik Hooijberg, Karin de Visser, Esther Lips, Jelle Wesseling, on behalf of the PRECISION team (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now). Progression of ductal carcinoma in situ (DCIS), is it in the immune microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2806.
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Affiliation(s)
| | - Lindy Visser
- 1Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Bram Thijssen
- 1Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Petra Kristel
- 1Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Lodewyk Wessels
- 2Netherlands Cancer Institute, Oncode Institute, Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Esther Lips
- 1Netherlands Cancer Institute, Amsterdam, Netherlands
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van Rooijen C, Bosch G, van der Poel AFB, Wierenga PA, Alexander L, Hendriks WH. Quantitation of Maillard reaction products in commercially available pet foods. J Agric Food Chem 2014; 62:8883-8891. [PMID: 25088431 DOI: 10.1021/jf502064h] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
During processing of pet food, the Maillard reaction occurs, which reduces the bioavailability of essential amino acids such as lysine and results in the formation of advanced Maillard reaction products (MRPs). The aim of this study was to quantitate MRPs (fructoselysine (FL), carboxymethyllysine (CML), hydroxymethylfurfural (HMF)) and the cross-link lysinoalanine (LAL) in commercial pet foods. Sixty-seven extruded, canned, and pelleted dog and cat foods for growth and maintenance were analyzed using UPLC-MS. Canned pet foods contained on average the most FL, CML, and HMF (4534, 37, and 1417 mg/kg dry matter, respectively) followed by pelleted and extruded foods. Average daily intake (mg/kg body weight(0.75)) of HMF is 122 times higher for dogs and 38 times higher for cats than average intake for adult humans. As commercial pet foods are most often the only source of food for dogs and cats, future research focus should be on the bioavailability and long-term health implications of MRP consumption by dogs and cats.
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Affiliation(s)
- Charlotte van Rooijen
- Animal Nutrition Group, Wageningen University , P.O. Box 338, 6700 AH Wageningen, The Netherlands
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