1
|
Rigamonti A, Viatore M, Polidori R, Rahal D, Erreni M, Fumagalli MR, Zanini D, Doni A, Putignano AR, Bossi P, Voulaz E, Alloisio M, Rossi S, Zucali PA, Santoro A, Balzano V, Nisticò P, Feuerhake F, Mantovani A, Locati M, Marchesi F. Integrating AI-Powered Digital Pathology and Imaging Mass Cytometry Identifies Key Classifiers of Tumor Cells, Stroma, and Immune Cells in Non-Small Cell Lung Cancer. Cancer Res 2024; 84:1165-1177. [PMID: 38315789 PMCID: PMC10982643 DOI: 10.1158/0008-5472.can-23-1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/13/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
Artificial intelligence (AI)-powered approaches are becoming increasingly used as histopathologic tools to extract subvisual features and improve diagnostic workflows. On the other hand, hi-plex approaches are widely adopted to analyze the immune ecosystem in tumor specimens. Here, we aimed at combining AI-aided histopathology and imaging mass cytometry (IMC) to analyze the ecosystem of non-small cell lung cancer (NSCLC). An AI-based approach was used on hematoxylin and eosin (H&E) sections from 158 NSCLC specimens to accurately identify tumor cells, both adenocarcinoma and squamous carcinoma cells, and to generate a classifier of tumor cell spatial clustering. Consecutive tissue sections were stained with metal-labeled antibodies and processed through the IMC workflow, allowing quantitative detection of 24 markers related to tumor cells, tissue architecture, CD45+ myeloid and lymphoid cells, and immune activation. IMC identified 11 macrophage clusters that mainly localized in the stroma, except for S100A8+ cells, which infiltrated tumor nests. T cells were preferentially localized in peritumor areas or in tumor nests, the latter being associated with better prognosis, and they were more abundant in highly clustered tumors. Integrated tumor and immune classifiers were validated as prognostic on whole slides. In conclusion, integration of AI-powered H&E and multiparametric IMC allows investigation of spatial patterns and reveals tissue relevant features with clinical relevance. SIGNIFICANCE Leveraging artificial intelligence-powered H&E analysis integrated with hi-plex imaging mass cytometry provides insights into the tumor ecosystem and can translate tumor features into classifiers to predict prognosis, genotype, and therapy response.
Collapse
Affiliation(s)
- Alessandra Rigamonti
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan; Milan, Italy
| | - Marika Viatore
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan; Milan, Italy
| | - Rebecca Polidori
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan; Milan, Italy
| | - Daoud Rahal
- Department of Pathology, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
| | - Marco Erreni
- Unit of Advanced Optical Microscopy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Maria Rita Fumagalli
- Unit of Advanced Optical Microscopy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Damiano Zanini
- Unit of Advanced Optical Microscopy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Andrea Doni
- Unit of Advanced Optical Microscopy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Anna Rita Putignano
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
| | - Paola Bossi
- Department of Pathology, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
| | - Emanuele Voulaz
- Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Marco Alloisio
- Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Armando Santoro
- Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Vittoria Balzano
- Immunology and Immunotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paola Nisticò
- Immunology and Immunotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Alberto Mantovani
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
- The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Massimo Locati
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan; Milan, Italy
| | - Federica Marchesi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital; Rozzano (Milan), Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan; Milan, Italy
| |
Collapse
|
2
|
Isermann T, Schneider KL, Wegwitz F, De Oliveira T, Conradi LC, Volk V, Feuerhake F, Papke B, Stintzing S, Mundt B, Kühnel F, Moll UM, Schulz-Heddergott R. Enhancement of colorectal cancer therapy through interruption of the HSF1-HSP90 axis by p53 activation or cell cycle inhibition. bioRxiv 2024:2024.02.22.581507. [PMID: 38464125 PMCID: PMC10925225 DOI: 10.1101/2024.02.22.581507] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
The stress-associated molecular chaperone system is an actionable target in cancer therapies. It is ubiquitously upregulated in cancer tissues and enables tumorigenicity by stabilizing hundreds of oncoproteins and disturbing the stoichiometry of protein complexes. Most inhibitors target the key component heat-shock protein 90 (HSP90). However, although classical HSP90 inhibitors are highly tumor-selective, they fail in phase 3 clinical oncology trials. These failures are at least partly due to an interference with a negative feedback loop by HSP90 inhibition, known as heat-shock response (HSR): in response to HSP90 inhibition there is compensatory synthesis of stress-inducible chaperones, mediated by the transcription factor heat-shock factor 1 (HSF1). We recently identified that wildtype p53 (p53) actively reduces the HSR by repressing HSF1 via a p21-CDK4/6-MAPK-HSF1 axis. Here we test the hypothesis that in HSP90-based therapies simultaneous p53 activation or direct cell cycle inhibition interrupts the deleterious HSF1-HSR axis and improves the efficiency of HSP90 inhibitors. Indeed, we find that the clinically relevant p53 activator Idasanutlin suppresses the HSF1-HSR activity in HSP90 inhibitor-based therapies. This combination synergistically reduces cell viability and accelerates cell death in p53-proficient colorectal cancer (CRC) cells, murine tumor-derived organoids and patient-derived organoids (PDOs). Mechanistically, upon combination therapy human CRC cells strongly upregulate p53-associated pathways, apoptosis, and inflammatory immune pathways. Likewise, in the chemical AOM/DSS CRC model in mice, dual HSF1-HSP90 inhibition strongly represses tumor growth and remodels immune cell composition, yet displays only minor toxicities in mice and normal mucosa-derived organoids. Importantly, inhibition of the cyclin dependent kinases 4 and 6 (CDK4/6) under HSP90 inhibition phenocopies synergistic repression of the HSR in p53-proficient CRC cells. Even more important, in p53-deficient (mutp53-harboring) CRC cells, an HSP90 inhibition in combination with CDK4/6 inhibitors similarly suppresses the HSF1-HSR system and reduces cancer growth. Likewise, p53-mutated PDOs strongly respond to dual HSF1-HSP90 pathway inhibition and thus, providing a strategy to target CRC independent of the p53 status. In sum, activating p53 (in p53-proficient cancer cells) or inhibiting CDK4/6 (independent of the p53 status) provide new options to improve the clinical outcome of HSP90-based therapies and to enhance colorectal cancer therapy.
Collapse
Affiliation(s)
- Tamara Isermann
- Department of Molecular Oncology, University Medical Center Göttingen, Göttingen, Germany
- Charité – Universitätsmedizin Berlin, Institute of Pathology, Laboratory of Molecular Tumor Pathology and Systems Biology, Berlin, Germany
- German Cancer Consortium (DKTK); Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kim Lucia Schneider
- Department of Molecular Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Florian Wegwitz
- Department of Gynecology and Obstetrics, University Medical Center Göttingen, Göttingen, Germany
| | - Tiago De Oliveira
- Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen, Germany
| | - Lena-Christin Conradi
- Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen, Germany
| | - Valery Volk
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Björn Papke
- Charité – Universitätsmedizin Berlin, Institute of Pathology, Laboratory of Molecular Tumor Pathology and Systems Biology, Berlin, Germany
- German Cancer Consortium (DKTK); Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Stintzing
- Charité – Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Berlin, Germany
| | - Bettina Mundt
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Florian Kühnel
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Ute M. Moll
- Department of Pathology, Stony Brook University, Stony Brook, NY
| | | |
Collapse
|
3
|
Schwarze S, Schaadt NS, Sobotta VMG, Spicher N, Skripuletz T, Esmaeilzadeh M, Krauss JK, Hartmann C, Deserno TM, Feuerhake F. Task design for crowdsourced glioma cell annotation in microscopy images. Sci Rep 2024; 14:1965. [PMID: 38263411 PMCID: PMC10805723 DOI: 10.1038/s41598-024-51995-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
Crowdsourcing has been used in computational pathology to generate cell and cell nuclei annotations for machine learning. Herein, we broaden its scope to the previously unsolved challenging task of glioma cell detection. This requires multiplexed immunofluorescence microscopy due to diffuse invasiveness and exceptional similarity between glioma cells and reactive astrocytes. In four pilot experiments, we iteratively developed a task design enabling high-quality annotations by crowdworkers on Amazon Mechanical Turk. We applied majority or weighted vote and validated them against ground truth in the final setting. On the base of a YOLO convolutional neural network architecture, we used these consensus labels for training with different image representations regarding colors, intensities, and immmunohistochemical marker combinations. A crowd of 712 workers defined aggregated point annotations in 235 images with an average [Formula: see text] score of 0.627 for majority vote. The networks resulted in acceptable [Formula: see text] scores up to 0.69 for YOLOv8 on average and indicated first evidence for transferability to images lacking tumor markers, especially in IDH-wildtype glioblastoma. Our work confirms feasibility of crowdsourcing to generate labels suitable for training of machine learning tools in the challenging and clinically relevant use case of glioma microenvironment.
Collapse
Affiliation(s)
- Svea Schwarze
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Nadine S Schaadt
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Viktor M G Sobotta
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Nicolai Spicher
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | | | | | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Thomas M Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Friedrich Feuerhake
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany.
- Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany.
| |
Collapse
|
4
|
Weber CAM, Krönke N, Volk V, Auber B, Förster A, Trost D, Geffers R, Esmaeilzadeh M, Lalk M, Nabavi A, Samii A, Krauss JK, Feuerhake F, Hartmann C, Wiese B, Brand F, Weber RG. Rare germline variants in POLE and POLD1 encoding the catalytic subunits of DNA polymerases ε and δ in glioma families. Acta Neuropathol Commun 2023; 11:184. [PMID: 37990341 PMCID: PMC10664377 DOI: 10.1186/s40478-023-01689-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023] Open
Abstract
Pathogenic germline variants in the DNA polymerase genes POLE and POLD1 cause polymerase proofreading-associated polyposis, a dominantly inherited disorder with increased risk of colorectal carcinomas and other tumors. POLE/POLD1 variants may result in high somatic mutation and neoantigen loads that confer susceptibility to immune checkpoint inhibitors (ICIs). To explore the role of POLE/POLD1 germline variants in glioma predisposition, whole-exome sequencing was applied to leukocyte DNA of glioma patients from 61 tumor families with at least one glioma case each. Rare heterozygous POLE/POLD1 missense variants predicted to be deleterious were identified in glioma patients from 10 (16%) families, co-segregating with the tumor phenotype in families with available DNA from several tumor patients. Glioblastoma patients carrying rare POLE variants had a mean overall survival of 21 months. Additionally, germline variants in POLD1, located at 19q13.33, were detected in 2/34 (6%) patients with 1p/19q-codeleted oligodendrogliomas, while POLE variants were identified in 2/4 (50%) glioblastoma patients with a spinal metastasis. In 13/15 (87%) gliomas from patients carrying POLE/POLD1 variants, features of defective polymerase proofreading, e.g. hypermutation, POLE/POLD1-associated mutational signatures, multinucleated cells, and increased intratumoral T cell response, were observed. In a CRISPR/Cas9-derived POLE-deficient LN-229 glioblastoma cell clone, a mutator phenotype and delayed S phase progression were detected compared to wildtype POLE cells. Our data provide evidence that rare POLE/POLD1 germline variants predispose to gliomas that may be susceptible to ICIs. Data compiled here suggest that glioma patients carrying POLE/POLD1 variants may be recognized by cutaneous manifestations, e.g. café-au-lait macules, and benefit from surveillance colonoscopy.
Collapse
Affiliation(s)
- Christine A M Weber
- Department of Human Genetics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nicole Krönke
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Valery Volk
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Bernd Auber
- Department of Human Genetics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Alisa Förster
- Department of Human Genetics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Robert Geffers
- Genome Analytics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Michael Lalk
- Department of Neurosurgery, KRH Klinikum Nordstadt, Hannover, Germany
| | - Arya Nabavi
- Department of Neurosurgery, KRH Klinikum Nordstadt, Hannover, Germany
| | - Amir Samii
- Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Friedrich Feuerhake
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
- Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Bettina Wiese
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
- Department of Neurology, Henriettenstift, Diakovere Krankenhaus gGmbH, Hannover, Germany
| | - Frank Brand
- Department of Human Genetics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ruthild G Weber
- Department of Human Genetics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| |
Collapse
|
5
|
Ratuszny D, Skripuletz T, Stüber T, Valizada E, Gehring K, Ertl P, Müller JA, Wattjes MP, Feuerhake F, Sühs KW. Anti-GABA-A Receptor Antibody-Mediated Epilepsia Partialis Continua After Treatment With Alemtuzumab: A Case Report. Neurol Neuroimmunol Neuroinflamm 2023; 10:10/4/e200123. [PMID: 37202183 DOI: 10.1212/nxi.0000000000200123] [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] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/20/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Patients with anti-GABA-A receptor encephalitis characteristically experience therapy-refractory epileptic seizures. General anesthesia is often required to terminate refractory status epilepticus. The immunologic mechanisms leading to antibody formation remain to be elucidated. Described triggers of anti-GABA-A autoimmunity are tumors, mainly thymomas, and herpes simplex encephalitis. METHODS We present a young woman with prediagnosis of relapse remitting multiple sclerosis (MS), treated with interferons, natalizumab, and alemtuzumab. Six months after one and only cycle of alemtuzumab, speech arrest and behavioral changes with aggressive and anxious traits appeared. She showed increasing motor convulsions resulting in focal status epilepticus. RESULTS Anti-GABA-A receptor antibodies in CSF and serum were confirmed in different external laboratories, in a more extensive analysis after antibodies against NMDAR, CASPR2, LGI1, GABABR, and AMPAR were ruled out during in-house examination. Clinical condition improved temporarily with cortisone therapy, plasmapheresis, and IVIG but deteriorated rapidly after steroid discontinuation, resulting in brain biopsy. On histopathologic confirmation consistent with anti-GABA-A receptor antibody-associated CNS inflammation, completing the first rituximab cycle, continuing oral corticosteroids and supplementing immunosuppression with cyclosporine A led to quick recovery. DISCUSSION Our case describes a severe autoantibody-induced encephalitis in a young patient with MS, with alemtuzumab as a potential trigger for anti-GABA-A receptor encephalitis.
Collapse
Affiliation(s)
- Dominica Ratuszny
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
| | - Thomas Skripuletz
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Thomas Stüber
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Emil Valizada
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Klaus Gehring
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Philipp Ertl
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Jörg Andreas Müller
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Mike P Wattjes
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Friedrich Feuerhake
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| | - Kurt-Wolfram Sühs
- From the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany
| |
Collapse
|
6
|
Graen P, Christiansen H, Polemikos M, Heetfeld C, Feuerhake F, Wiese B, Merten R. Moderately Hypofractionated Radio(chemo)therapy With Simultaneous Integrated Boost for Recurrent, Previously Irradiated, High-grade Glioma. Anticancer Res 2023; 43:2155-2160. [PMID: 37097672 DOI: 10.21873/anticanres.16377] [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: 02/11/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND/AIM The therapy of recurrent, previously irradiated, high-grade gliomas is still a major interdisciplinary challenge, and the overall prognosis remains poor. Reirradiation has been established as a major component of the management of relapse, in addition to further debulking surgery and systemic options. Herein, we present a moderately hypofractionated reirradiation concept with simultaneous integrated boost for such recurrent, previously irradiated tumors. PATIENTS AND METHODS From October 2019 to January 2021, 12 patients with recurrent malignant gliomas were re-irradiated. All patients had previously undergone surgery and irradiation with mostly normal fractions at the time of primary therapy. Radiotherapy of relapse was performed in all patients with 33 Gy, with 2.2 Gy single dose with a simultaneously integrated boost of 40.05 Gy with a single dose of 2.67 Gy in 15 fractions. Nine out of the 12 patients underwent debulking surgery before reirradiation, and seven patients received concurrent chemotherapy with temozolomide. The mean follow-up was 15.5 months. RESULTS The median overall survival after recurrence was 9.3 months. The survival rate after 1 year was 33%. Toxicity during radiotherapy was low. In two patients, small areas of radionecrosis were observed at follow-up magnetic resonance imaging in the target volume; these patients were clinically asymptomatic. CONCLUSION Moderate hypofractionation shortens the duration of radiotherapy and thereby improves accessibility for patients with limited mobility and prognosis, and achieves a respectable overall survival rate. Furthermore, the extent of late toxicity is also acceptable in these preirradiated patients.
Collapse
Affiliation(s)
- Pascal Graen
- Clinic for Radiotherapy, Hannover Medical School, Hannover, Germany
| | | | | | | | | | - Bettina Wiese
- Clinic for Neurosurgery, Hannover Medical School, Hannover, Germany
- Clinic for Neurooncology, Diakovere Hospital, Hannover, Germany
| | - Roland Merten
- Clinic for Radiotherapy, Hannover Medical School, Hannover, Germany;
| |
Collapse
|
7
|
Thiesler H, Gretenkort L, Hoffmeister L, Albers I, Ohlmeier L, Röckle I, Verhagen A, Banan R, Köpcke N, Krönke N, Feuerhake F, Behling F, Barrantes-Freer A, Mielke D, Rohde V, Hong B, Varki A, Schwabe K, Krauss JK, Stadelmann C, Hartmann C, Hildebrandt H. Proinflammatory macrophage activation by the polysialic acid-Siglec-16 axis is linked to increased survival of glioblastoma patients. Clin Cancer Res 2023:725902. [PMID: 37058255 DOI: 10.1158/1078-0432.ccr-22-1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Interactions with tumor-associated microglia and macrophages (TAM) are critical for glioblastoma progression. Polysialic acid (polySia) is a tumor-associated glycan, but its frequency of occurrence and its prognostic value in glioblastoma are disputed. Through interactions with the opposing immune receptors Siglec-11 and Siglec-16, polySia is implicated in the regulation of microglia and macrophage activity. However, due to a nonfunctional SIGLEC16P allele, SIGLEC16 penetrance is less than 40%. Here, we explored possible consequences of SIGLEC16 status and tumor cell-associated polySia on glioblastoma outcome. EXPERIMENTAL DESIGN FFPE specimens of two independent cohorts with 70 and 100 newly diagnosed glioblastoma patients were retrospectively analyzed for SIGLEC16 and polySia status in relation to overall survival. Inflammatory TAM activation was assessed in tumors, in heterotypic tumor spheroids consisting of polySia-positive glioblastoma cells and Siglec-16-positive or -negative macrophages, and by exposing Siglec-16-positive or -negative macrophages to glioblastoma cell-derived membrane fractions. RESULTS Overall survival of SIGLEC16 carriers with polySia-positive tumors was increased. Consistent with proinflammatory Siglec-16 signaling, levels of TAM positive for the M2 marker CD163 were reduced, whereas the M1 marker CD74 and TNF expression were increased, and CD8+ T cells enhanced in SIGLEC16 polySia double-positive tumors. Correspondingly, TNF production was elevated in heterotypic spheroid cultures with Siglec-16-expressing macrophages. Furthermore, a higher, mainly M1-like cytokine release and activating immune signaling was observed in SIGLEC16-positive as compared to SIGLEC16-negative macrophages confronted with glioblastoma cell-derived membranes. CONCLUSIONS Collectively, these results strongly suggest that proinflammatory TAM activation causes the better outcome in glioblastoma patients with a functional polySia-Siglec-16 axis.
Collapse
Affiliation(s)
- Hauke Thiesler
- Hannover Medical School, Hannover, Lower Saxony, Germany
| | | | | | - Iris Albers
- Hannover Medical School, Hannover, Lower Saxony, Germany
| | | | | | - Andrea Verhagen
- University of California, San Diego, La Jolla, CA, United States
| | | | | | | | | | | | | | | | - Veit Rohde
- Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University Göttingen, Germany, Germany
| | | | - Ajit Varki
- University of California, San Diego, La Jolla, CA, United States
| | | | | | | | | | | |
Collapse
|
8
|
Graeser M, Kuemmel S, Gluz O, Feuerhake F, Volk V, Ulbrich-Gebauer D, Biehl C, Reinisch M, Kostara9 A, Scheffen I, Luedtke-Heckenkamp K, Hartkopf A, Hilpert F, Kentsch A, Ziske C, Depenbusch R, Braun M, Blohmer JU, zu Eulenburg C, Christgen M, Kates R, Bartels S, Kreipe HH, Pelz E, Schmid P, Harbeck N. Abstract P5-02-03: Combined biomarker analysis for prediction of pathological complete response (pCR) after 12 weeks of pembrolizumab + trastuzumab + pertuzumab in HER2-enriched early breast cancer: Keyriched-1 trial. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-03] [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: 03/06/2023]
Abstract
Abstract
Background In unselected HER2+ early breast cancer (EBC), de-escalated chemotherapy-free neoadjuvant therapy (NAT) with dual HER2-blockade induces pCR rates of only 20%-40%. In order to achieve pCR rates by de-escalated therapy comparable to those achieved by chemotherapy-based regimens, patient selection and more effective chemotherapy-free regimens are thus key. KEYRICHED-1 (NCT03988036), a single-arm phase 2 study, is the first trial to investigate chemotherapy-free NAT with dual HER2 blockade and pembrolizumab in HER2-enriched HER2+ EBC. In a translational subproject, we analyzed gene signatures together with tumor cell proliferation and spatiotemporal immune cell profiling to identify predictive factors for pCR. Methods 48 pre- and postmenopausal patients with newly diagnosed HER2 2+ (ISH positive) or 3+ EBC (stage I-III) and HER2-enriched (HER2-E) subtype by PAM50 were included in the study. All patients received 4 cycles of pembrolizumab (200 mg), trastuzumab biosimilar ABP 980 (loading dose (LD) 8 mg/kg bodyweight (BW), maintenance dose (MD) 6 mg/kg BW), and pertuzumab (LD 840 mg/kg BW, MD 420 mg/kg BW) q21d. Primary objective was pCR (centrally confirmed absence of invasive tumor in breast and lymph nodes: ypT0/is, ypN0). NanoString Breast Cancer 360 panel was performed in baseline biopsies (n=42). ≥30% Ki67 decrease, < 500 invasive tumor cells or no evidence of tumor in week 3 biopsies (on treatment) were classified as early response. sTILs were analyzed at baseline (n=42) and week 3 (n=28). Ongoing analyses include whole exome sequencing and multiplexed immunohistochemistry for expression of PD1, PDL1, CD4, CD8, CD68, and CD20 levels in tumor and stroma at baseline and at week 3. Impact of standardized expression of single genes, signatures, and sTILs on pCR was evaluated with univariable and multivariate logistic regression analyses and summarized with odds ratios (OR) and 95% confidence intervals (95%CI). Results 42 patients with BC360 and sTILs data at baseline were included in the analysis. Median age was 55 years (range: 22-83), 11 patients (31%) had node-positive EBC. At baseline, 28 patients had sTIL levels ≥30% and 14 had sTILs < 30%; the corresponding pCR rates were 57.1% (n=16) and 28.6% (n=4, p=0.108). At week 3 (on treatment), 16 patients had sTIL levels ≥30%, 50% (n=8) had a pCR vs 8.3% in those with < 30% sTILs (one patient out of 12, p=0.039). 37 patients had early response, 54.1% of them (n=20) had a pCR vs 0% in early non-responders (n=5, p=0.049). In univariate analysis, IDO1, ERBB2, IFNγ, cytotoxic cells, cytotoxicity, CD8 T-cells, TIGIT, and tumor inflammation signatures were statistically significantly associated with pCR (OR 2.3-3.6); ERBB2, IDO1, IFNγ and CD8 T-cells remained significant after adjusting for hormone receptor (HR) and central HER2 status (OR 2.2-4.3). 70 single genes were predictive for pCR; none of them remained significant after false discovery rate adjustment (25%). In multivariable analysis for baseline markers including signatures, sTILs, HR and central HER2 status, only ERBB2 (OR 8.7, 95%CI 1.9-39.0, p=0.0046) and cytotoxic cells signatures (OR 4.6, 95%CI 1.6-13.5, p=0.0059) were predictive for pCR. Results of whole exome sequencing, and multiplexed immunohistochemistry analysis of immune cell markers will be presented at the Symposium. Conclusions Biomarker analysis in the unique KEYRICHED-1 cohort revealed that early response at week 3, ERBB2 and immune related signatures as well as on-therapy sTIL levels predict pCR after a chemotherapy-free combination of immunotherapy and dual HER2 blockade in HER2-enriched EBC. These results pave the way for validation in larger de-escalation trials investigating short, chemotherapy-free regimens in selected patients with HER2+ EBC. Funding for this research was provided by MSD Sharp & Dohme GmbH.
Citation Format: Monika Graeser, Sherko Kuemmel, Oleg Gluz, Friedrich Feuerhake, Valery Volk, Daniel Ulbrich-Gebauer, Claudia Biehl, Mattea Reinisch, Athina Kostara9, Iris Scheffen, Kerstin Luedtke-Heckenkamp, Andreas Hartkopf, Felix Hilpert, Angela Kentsch, Carsten Ziske, Reinhard Depenbusch, Michael Braun, Jens-Uwe Blohmer, Christine zu Eulenburg, Matthias Christgen, Ronald Kates, Stephan Bartels, Hans-Heinrich Kreipe, Enrico Pelz, Peter Schmid, Nadia Harbeck. Combined biomarker analysis for prediction of pathological complete response (pCR) after 12 weeks of pembrolizumab + trastuzumab + pertuzumab in HER2-enriched early breast cancer: Keyriched-1 trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-03.
Collapse
Affiliation(s)
- Monika Graeser
- 1West German Study Group, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Moenchengladbach, Germany; Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany
| | - Sherko Kuemmel
- 2West German Study Group, Moenchengladbach, Germany; Breast Unit, Kliniken Essen-Mitte, Essen, Germany; Charité - Universitätsmedizin Berlin, Department of Gynecology with Breast Center, Berlin, Germany
| | - Oleg Gluz
- 3West German Study Group, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Moenchengladbach, Germany; University Clinics Cologne, Cologne, Germany
| | - Friedrich Feuerhake
- 4Medical School Hannover, Institute of Pathology, Hannover, Germany; Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Valery Volk
- 5Medical School Hannover, Institute of Pathology, Hannover, Germany; Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | | | - Claudia Biehl
- 7Westphalian Breast Center Dortmund, Dortmund, Germany
| | - Mattea Reinisch
- 8Interdisciplinary Breast Cancer Center/Breast Unit, Essen, Germany
| | - Athina Kostara9
- 1West German Study Group, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Moenchengladbach, Germany; Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany
| | - Iris Scheffen
- 10West German Study Group, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Moenchengladbach, Germany
| | | | - Andreas Hartkopf
- 12Women’s Clinic, University Clinics Tuebingen, Tuebingen, Germany
| | - Felix Hilpert
- 13Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) and North-Eastern German Society of Gynecologcial Oncology (NOGGO), Berlin, Germany; Onkologisches Therapiezentrum, Krankenhaus Jerusalem, Hamburg, Germany
| | - Angela Kentsch
- 14Diakovere Henriettenstift, Dept. for Gynecology, Hanover, Germany
| | - Carsten Ziske
- 15Praxis Dr. H. Forstbauer, C. Ziske, R. Reihs, E. Rodermann, A. Diel, Troisdorf, Germany
| | | | | | | | - Christine zu Eulenburg
- 19West German Study Group, Moenchengladbach, Germany; Department of Medical Biometry and Epidemiology, University Medical Center Hamburg, Hamburg, Germany
| | | | - Ronald Kates
- 21West German Study Group, Moenchengladbach, Germany
| | - Stephan Bartels
- 22Medical School Hannover, Institute of Pathology, Hannover, Germany; Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Hans-Heinrich Kreipe
- 23Medical School Hannover, Institute of Pathology, Hannover, Germany; Institute of Neuropathology
| | | | - Peter Schmid
- 25Bart’s Cancer Institute, London, United Kingdom
| | | |
Collapse
|
9
|
Graeser M, Gluz O, Biehl C, Ulbrich-Gebauer D, Christgen M, Palatty J, Kuemmel S, Grischke EM, Augustin D, Braun M, Potenberg J, Wuerstlein R, Krauss K, Schumacher C, Forstbauer H, Reimer T, Stefek A, Fischer HH, Pelz E, zu Eulenburg C, Kates R, Ni H, Kolberg-Liedtke C, Feuerhake F, Kreipe HH, Nitz U, Harbeck N. Impact of RNA Signatures on pCR and Survival after 12-Week Neoadjuvant Pertuzumab plus Trastuzumab with or without Paclitaxel in the WSG-ADAPT HER2+/HR- Trial. Clin Cancer Res 2023; 29:805-814. [PMID: 36441798 PMCID: PMC9932580 DOI: 10.1158/1078-0432.ccr-22-1587] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/26/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To identify associations of biological signatures and stromal tumor-infiltrating lymphocytes (sTIL) with pathological complete response (pCR; ypT0 ypN0) and survival in the Phase II WSG-ADAPT HER2+/HR- trial (NCT01817452). EXPERIMENTAL DESIGN Patients with cT1-cT4c, cN0-3 HER2+/HR- early breast cancer (EBC) were randomized to pertuzumab+trastuzumab (P+T, n = 92) or P+T+paclitaxel (n = 42). Gene expression signatures were analyzed in baseline biopsies using NanoString Breast Cancer 360 panel (n = 117); baseline and on-treatment (week 3) sTIL levels were available in 119 and 76 patients, respectively. Impacts of standardized gene expression signatures on pCR and invasive disease-free survival (iDFS) were estimated by logistic and Cox regression. RESULTS In all patients, ERBB2 [OR, 1.70; 95% confidence interval (CI), 1.08-2.67] and estrogen receptor (ER) signaling (OR, 1.72; 95% CI, 1.13-2.61) were favorable, whereas PTEN (OR, 0.57; 95% CI, 0.38-0.87) was unfavorable for pCR. After 60 months median follow-up, 13 invasive events occurred (P+T: n = 11, P+T+paclitaxel: n = 2), none following pCR. Gene signatures related to immune response (IR) and ER signaling were favorable for iDFS, all with similar HR about 0.43-0.55. These patterns were even more prominent in the neoadjuvant chemotherapy-free group, where additionally BRCAness signature was unfavorable (HR, 2.00; 95% CI, 1.04-3.84). IR signatures were strongly intercorrelated. sTILs (baseline/week 3/change) were not associated with pCR or iDFS, though baseline sTILs correlated positively with IR signatures. CONCLUSIONS Distinct gene signatures were associated with pCR versus iDFS in HER2+/HR- EBC. The potential role of IR in preventing recurrence suggests that patients with upregulated IR signatures could be candidates for de-escalation concepts in HER2+ EBC.
Collapse
Affiliation(s)
- Monika Graeser
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany.,Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany.,Corresponding Author: Monika Graeser, Bethesda Hospital, West German Study Group, University Medical Center Hamburg—Eppendorf, Moenchengladbach and Hamburg 41061, Germany. Phone: 49-216-1981-2330; Fax: 49-216-1566-2319; E-mail:
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany.,University Clinics Cologne, Women's Clinic and Breast Center, Cologne, Germany
| | - Claudia Biehl
- Westphalian Brest Center Dortmund, Dortmund, Germany
| | | | | | | | - Sherko Kuemmel
- West German Study Group, Moenchengladbach, Germany.,Breast Unit, Kliniken Essen-Mitte, Essen, Germany.,Department of Gynecology with Breast Center, University Hospital Charité, Humboldt University, Berlin, Germany
| | | | | | - Michael Braun
- Department of Gynecology, Breast Center, Red Cross Hospital Munich, Munich, Germany
| | | | - Rachel Wuerstlein
- West German Study Group, Moenchengladbach, Germany.,Department of Gynecology and Obstetrics and CCCLMU, Breast Center, LMU University Hospital, Munich, Germany
| | - Katja Krauss
- University Hospital Aachen, Breast Center, Aachen, Germany
| | | | | | - Toralf Reimer
- University Hospital Gynecology and Policlinic Rostock, Rostock, Germany
| | - Andrea Stefek
- Johanniter Women's Clinic Stendal, Breast Center, Stendal, Germany
| | | | | | - Christine zu Eulenburg
- West German Study Group, Moenchengladbach, Germany.,Department of Medical Biometry and Epidemiology, University Medical Center Hamburg, Hamburg, Germany
| | - Ronald Kates
- West German Study Group, Moenchengladbach, Germany
| | - Hua Ni
- Department of Gynecology and Obstetrics and CCCLMU, Breast Center, LMU University Hospital, Munich, Germany
| | - Cornelia Kolberg-Liedtke
- Department of Gynecology with Breast Center, University Hospital Charité, Humboldt University, Berlin, Germany.,University Clinics Essen, Women's Clinic, Essen, Germany
| | - Friedrich Feuerhake
- Medical School Hannover, Institute of Pathology, Hannover, Germany.,Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | | | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Department of Gynecology and Obstetrics and CCCLMU, Breast Center, LMU University Hospital, Munich, Germany
| |
Collapse
|
10
|
Berijanian M, Schaadt NS, Huang B, Lotz J, Feuerhake F, Merhof D. Unsupervised many-to-many stain translation for histological image augmentation to improve classification accuracy. J Pathol Inform 2023; 14:100195. [PMID: 36844704 PMCID: PMC9947329 DOI: 10.1016/j.jpi.2023.100195] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Background Deep learning tasks, which require large numbers of images, are widely applied in digital pathology. This poses challenges especially for supervised tasks since manual image annotation is an expensive and laborious process. This situation deteriorates even more in the case of a large variability of images. Coping with this problem requires methods such as image augmentation and synthetic image generation. In this regard, unsupervised stain translation via GANs has gained much attention recently, but a separate network must be trained for each pair of source and target domains. This work enables unsupervised many-to-many translation of histopathological stains with a single network while seeking to maintain the shape and structure of the tissues. Methods StarGAN-v2 is adapted for unsupervised many-to-many stain translation of histopathology images of breast tissues. An edge detector is incorporated to motivate the network to maintain the shape and structure of the tissues and to have an edge-preserving translation. Additionally, a subjective test is conducted on medical and technical experts in the field of digital pathology to evaluate the quality of generated images and to verify that they are indistinguishable from real images. As a proof of concept, breast cancer classifiers are trained with and without the generated images to quantify the effect of image augmentation using the synthetized images on classification accuracy. Results The results show that adding an edge detector helps to improve the quality of translated images and to preserve the general structure of tissues. Quality control and subjective tests on our medical and technical experts show that the real and artificial images cannot be distinguished, thereby confirming that the synthetic images are technically plausible. Moreover, this research shows that, by augmenting the training dataset with the outputs of the proposed stain translation method, the accuracy of breast cancer classifier with ResNet-50 and VGG-16 improves by 8.0% and 9.3%, respectively. Conclusions This research indicates that a translation from an arbitrary source stain to other stains can be performed effectively within the proposed framework. The generated images are realistic and could be employed to train deep neural networks to improve their performance and cope with the problem of insufficient numbers of annotated images.
Collapse
Affiliation(s)
- Maryam Berijanian
- Department of Computational Mathematics, Science and Engineering (CMSE), Michigan State University, East Lansing, USA,Institute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | | | - Boqiang Huang
- Institute of Image Analysis and Computer Vision, Faculty of Informatics and Data Science, University of Regensburg, Regensburg, Germany
| | - Johannes Lotz
- Fraunhofer Institute for Digital Medicine MEVIS, Lübeck, Germany
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany,Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Dorit Merhof
- Institute of Image Analysis and Computer Vision, Faculty of Informatics and Data Science, University of Regensburg, Regensburg, Germany,Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany,Corresponding author at: University of Regensburg, 93040 Regensburg, Germany.
| |
Collapse
|
11
|
Vasiljević J, Nisar Z, Feuerhake F, Wemmert C, Lampert T. CycleGAN for virtual stain transfer: Is seeing really believing? Artif Intell Med 2022; 133:102420. [PMID: 36328671 DOI: 10.1016/j.artmed.2022.102420] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/16/2022] [Accepted: 10/02/2022] [Indexed: 01/18/2023]
Abstract
Digital Pathology is an area prone to high variation due to multiple factors which can strongly affect diagnostic quality and visual appearance of the Whole-Slide-Images (WSIs). The state-of-the art methods to deal with such variation tend to address this through style-transfer inspired approaches. Usually, these solutions directly apply successful approaches from the literature, potentially with some task-related modifications. The majority of the obtained results are visually convincing, however, this paper shows that this is not a guarantee that such images can be directly used for either medical diagnosis or reducing domain shift.This article shows that slight modification in a stain transfer architecture, such as a choice of normalisation layer, while resulting in a variety of visually appealing results, surprisingly greatly effects the ability of a stain transfer model to reduce domain shift. By extensive qualitative and quantitative evaluations, we confirm that translations resulting from different stain transfer architectures are distinct from each other and from the real samples. Therefore conclusions made by visual inspection or pretrained model evaluation might be misleading.
Collapse
Affiliation(s)
- Jelica Vasiljević
- ICube, University of Strasbourg, CNRS (UMR 7357), France; University of Belgrade, Belgrade, Serbia; Faculty of Science, University of Kragujevac, Kragujevac, Serbia.
| | - Zeeshan Nisar
- ICube, University of Strasbourg, CNRS (UMR 7357), France
| | - Friedrich Feuerhake
- Institute of Pathology, Hannover Medical School, Germany; University Clinic, Freiburg, Germany
| | - Cédric Wemmert
- ICube, University of Strasbourg, CNRS (UMR 7357), France
| | - Thomas Lampert
- ICube, University of Strasbourg, CNRS (UMR 7357), France
| |
Collapse
|
12
|
Kolberg-Liedtke C, Feuerhake F, Garke M, Christgen M, Kates R, Grischke EM, Forstbauer H, Braun M, Warm M, Hackmann J, Uleer C, Aktas B, Schumacher C, Kuemmel S, Wuerstlein R, Graeser M, Nitz U, Kreipe H, Gluz O, Harbeck N. Impact of stromal tumor-infiltrating lymphocytes (sTILs) on response to neoadjuvant chemotherapy in triple-negative early breast cancer in the WSG-ADAPT TN trial. Breast Cancer Res 2022; 24:58. [PMID: 36056374 PMCID: PMC9438265 DOI: 10.1186/s13058-022-01552-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Higher density of stromal tumor-infiltrating lymphocytes (sTILs) at baseline has been associated with increased rates of pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC). While evidence supports favorable association of pCR with survival in TNBC, an independent impact of sTILs (after adjustment for pCR) on survival is not yet established. Moreover, the impact of sTIL dynamics during NACT on pCR and survival in TNBC is unknown. METHODS The randomized WSG-ADAPT TN phase II trial compared efficacy of 12-week nab-paclitaxel with gemcitabine versus carboplatin. This preplanned translational analysis assessed impacts of sTIL measurements at baseline (sTIL-0) and after 3 weeks of chemotherapy (sTIL-3) on pCR and invasive disease-free survival (iDFS). Predictive performance of sTIL-0 and sTIL-3 for pCR was quantified by ROC analysis and logistic regression; Kaplan-Meier estimation and Cox regression (with mediation analysis) were used to determine their impact on iDFS. RESULTS For prediction of pCR, the AUC statistics for sTIL-0 and sTIL-3 were 0.60 and 0.63, respectively, in all patients; AUC for sTIL-3 was higher in NP/G. The positive predictive value (PPV) of "lymphocyte-predominant" status (sTIL-0 ≥ 60%) at baseline was 59.3%, though only 13.0% of patients had this status. To predict non-pCR, the cut point sTIL-0 ≤ 10% yielded PPV = 69.5% while addressing 33.8% of patients. Higher sTIL levels (particularly at 3 weeks) were independently and favorably associated with better iDFS, even after adjusting for pCR. For example, the adjusted hazard ratio for 3-week sTILs ≥ 60% (vs. < 60%) was 0.48 [0.23-0.99]. Low cellularity in 3-week biopsies was the strongest individual predictor for pCR (in both therapy arms), but not for iDFS. CONCLUSION The independent impact of sTILs on iDFS suggests that favorable immune response can influence key tumor biological processes for long-term survival. The results suggest that the reliability of pCR following neoadjuvant therapy as a surrogate for survival could vary among subgroups in TNBC defined by immune response or other factors. Dynamic measurements of sTILs under NACT could support immune response-guided patient selection for individualized therapy approaches for both very low levels (more effective therapies) and very high levels (de-escalation concepts). TRIAL REGISTRATION Clinical trials No: NCT01815242, retrospectively registered January 25, 2013.
Collapse
Affiliation(s)
- Cornelia Kolberg-Liedtke
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | | | | | | | - Ronald Kates
- West German Study Group, Mönchengladbach, Germany
| | | | | | - Michael Braun
- Breast Center, Rotkreuz Clinics Munich, Munich, Germany
| | - Mathias Warm
- Breast Center, City Hospital Holweide, Cologne, Germany
| | | | | | - Bahriye Aktas
- Department of Gynecology, University Hospital Leipzig, Leipzig, Germany
| | | | - Sherko Kuemmel
- West German Study Group, Mönchengladbach, Germany.,Breast Unit, Kliniken Essen-Mitte, Essen, Germany.,Department of Gynecology with Breast Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rachel Wuerstlein
- West German Study Group, Mönchengladbach, Germany.,Breast Center, LMU University Hospital, Munich, Germany
| | - Monika Graeser
- West German Study Group, Mönchengladbach, Germany.,University Hospital Hamburg-Eppendorf, Hamburg, Germany.,Breast Center Niederrhein, Ev. Hospital Bethesda, Mönchengladbach, Germany
| | - Ulrike Nitz
- West German Study Group, Mönchengladbach, Germany.,Breast Center Niederrhein, Ev. Hospital Bethesda, Mönchengladbach, Germany
| | - Hans Kreipe
- Institute of Pathology, Medical School Hannover, Hannover, Germany
| | - Oleg Gluz
- West German Study Group, Mönchengladbach, Germany.,Breast Center Niederrhein, Ev. Hospital Bethesda, Mönchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Mönchengladbach, Germany.,Breast Center, LMU University Hospital, Munich, Germany
| |
Collapse
|
13
|
Verstockt B, Volk V, Jaeckel C, Alsoud D, Sabino J, Nikolaus S, Outtier A, Krönke N, Feuerhake F, De Hertogh G, Rosenstiel P, Vermeire S, Schreiber S, Ferrante M, Aden K. Longitudinal monitoring of STAT3 phosphorylation and histologic outcome of tofacitinib therapy in patients with ulcerative colitis. Aliment Pharmacol Ther 2022; 56:282-291. [PMID: 35484689 DOI: 10.1111/apt.16955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/25/2022] [Accepted: 04/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tofacitinib is the first in class, pan-JAK inhibitor approved for ulcerative colitis (UC). Clinical efficacy has been shown, but long-term real-life endoscopic and histologic data are lacking. AIM To investigate the effects of tofacitinib in patients with refractory UC focussing on endoscopic, histologic and molecular outcomes, including STAT3 phosphorylation (pSTAT3) detection in the spatial context of mucosal inflammation METHODS: We prospectively monitored 59 highly refractory patients (96.7% anti-TNF exposure, 91.7% vedolizumab exposure) initiating tofacitinib at two IBD referral centres and assessed outcome at the end of induction and after 48 weeks of therapy. Endoscopic improvement was defined as a Mayo endoscopic subscore ≤1, endoscopic and histologic remission as Mayo endoscopic subscore 0 and Nancy histologic score 0. Multiplex immunohistochemistry with multispectral imaging was used to assess pSTAT3. RESULTS Endoscopic improvement was achieved by 24.4% and 30.5% of patients at weeks 8 and 48, respectively. Endoscopic and histologic remission rates were 11.1%, 23.7 and 16.7%, 21.4%, respectively. Endoscopic improvement at week 8 was significantly associated with treatment continuation in the long-term (72.7% vs 20.6%, p = 0.003). Although we observed a gradual decrease of mucosal pSTAT3 levels in both remitters and non-remitters (p < 0.05), no association with treatment outcome could be demonstrated. However, lamina propria pSTAT3 was significantly associated with the Nancy Histologic index (p = 0.004). CONCLUSION Tofacitinib can induce and maintain endoscopic and histologic remission in up to one-quarter of highly refractory UC patients. Longitudinal monitoring of nuclear pSTAT3 in mucosal tissue compartments reflects distinctive on-target effects, independently of long-term treatment outcomes.
Collapse
Affiliation(s)
- Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Translational Research in Gastrointestinal Disorders, Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Valery Volk
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Charlot Jaeckel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Dahham Alsoud
- Translational Research in Gastrointestinal Disorders, Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - João Sabino
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Translational Research in Gastrointestinal Disorders, Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Susanna Nikolaus
- Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - An Outtier
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Nicole Krönke
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Gert De Hertogh
- Laboratory of Morphology and Molecular Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Séverine Vermeire
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Translational Research in Gastrointestinal Disorders, Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Marc Ferrante
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Translational Research in Gastrointestinal Disorders, Department of Chronic Disease, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Konrad Aden
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
14
|
Oswald E, Bug D, Grote A, Lashuk K, Bouteldja N, Lenhard D, Löhr A, Behnke A, Knauff V, Edinger A, Klingner K, Gaedicke S, Niedermann G, Merhof D, Feuerhake F, Schueler J. Immune cell infiltration pattern in non-small cell lung cancer PDX models is a model immanent feature and correlates with a distinct molecular and phenotypic make-up. J Immunother Cancer 2022; 10:jitc-2021-004412. [PMID: 35483746 PMCID: PMC9052060 DOI: 10.1136/jitc-2021-004412] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The field of cancer immunology is rapidly moving towards innovative therapeutic strategies, resulting in the need for robust and predictive preclinical platforms reflecting the immunological response to cancer. Well characterized preclinical models are essential for the development of predictive biomarkers in the oncology as well as the immune-oncology space. In the current study, gold standard preclinical models are being refined and combined with novel image analysis tools to meet those requirements. METHODS A panel of 14 non-small cell lung cancer patient-derived xenograft models (NSCLC PDX) was propagated in humanized NOD/Shi-scid/IL-2Rnull mice. The models were comprehensively characterized for relevant phenotypic and molecular features, including flow cytometry, immunohistochemistry, histology, whole exome sequencing and cytokine secretion. RESULTS Models reflecting hot (>5% tumor-infiltrating lymphocytes/TILs) as opposed to cold tumors (<5% TILs) significantly differed regarding their cytokine profiles, molecular genetic aberrations, stroma content, and programmed cell death ligand-1 status. Treatment experiments including anti cytotoxic T-lymphocyte-associated protein 4, anti-programmed cell death 1 or the combination thereof across all 14 models in the single mouse trial format showed distinctive tumor growth response and spatial immune cell patterns as monitored by computerized analysis of digitized whole-slide images. Image analysis provided for the first time qualitative evaluation of the extent to which PDX models retain the histological features from their original human donors. CONCLUSIONS Deep phenotyping of PDX models in a humanized setting by combinations of computational pathology, immunohistochemistry, flow cytometry and proteomics enables the exhaustive analysis of innovative preclinical models and paves the way towards the development of translational biomarkers for immuno-oncology drugs.
Collapse
Affiliation(s)
- Eva Oswald
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Daniel Bug
- Institute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Anne Grote
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Kanstantsin Lashuk
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Nassim Bouteldja
- Institute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Dorothee Lenhard
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Anne Löhr
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Anke Behnke
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Volker Knauff
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Anna Edinger
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Kerstin Klingner
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| | - Simone Gaedicke
- Department of Radiation Oncology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Gabriele Niedermann
- Department of Radiation Oncology, Medical Center-University of Freiburg, Freiburg, Germany.,German Cancer Consortium, Heidelberg, Germany
| | - Dorit Merhof
- Institute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | | | - Julia Schueler
- Charles River Discovery Research Services Gemany GmbH, Charles River Laboratories Inc, Freiburg, Germany
| |
Collapse
|
15
|
Kemps PG, Picarsic J, Durham BH, Hélias-Rodzewicz Z, Hiemcke-Jiwa L, van den Bos C, van de Wetering MD, van Noesel CJM, van Laar JAM, Verdijk RM, Flucke UE, Hogendoorn PCW, Woei-A-Jin FJSH, Sciot R, Beilken A, Feuerhake F, Ebinger M, Möhle R, Fend F, Bornemann A, Wiegering V, Ernestus K, Méry T, Gryniewicz-Kwiatkowska O, Dembowska-Baginska B, Evseev DA, Potapenko V, Baykov VV, Gaspari S, Rossi S, Gessi M, Tamburrini G, Héritier S, Donadieu J, Bonneau-Lagacherie J, Lamaison C, Farnault L, Fraitag S, Jullié ML, Haroche J, Collin M, Allotey J, Madni M, Turner K, Picton S, Barbaro PM, Poulin A, Tam IS, El Demellawy D, Empringham B, Whitlock JA, Raghunathan A, Swanson AA, Suchi M, Brandt JM, Yaseen NR, Weinstein JL, Eldem I, Sisk BA, Sridhar V, Atkinson M, Massoth LR, Hornick JL, Alexandrescu S, Yeo KK, Petrova-Drus K, Peeke SZ, Muñoz-Arcos LS, Leino DG, Grier DD, Lorsbach R, Roy S, Kumar AR, Garg S, Tiwari N, Schafernak KT, Henry MM, van Halteren AGS, Abla O, Diamond EL, Emile JF. ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition. Blood 2022; 139:256-280. [PMID: 34727172 PMCID: PMC8759533 DOI: 10.1182/blood.2021013338] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.
Collapse
Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Benjamin H Durham
- Human Oncology and Pathogenesis Program, Department of Medicine, and
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| | | | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Marianne D van de Wetering
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine and Immunology, and
- Section of Clinical Immunology, Department of Immunology, and
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - F J Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Martin Ebinger
- Department I - General Pediatrics, Children's Hospital, Hematology and Oncology
| | | | - Falko Fend
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Bornemann
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Wiegering
- Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital Würzburg, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Tina Méry
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | - Dmitry A Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Vsevolod Potapenko
- Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia
- Department of Bone Marrow Transplantation and
| | - Vadim V Baykov
- Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Laboratories Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Gianpiero Tamburrini
- Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Donadieu
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Claire Lamaison
- Department of Pathology, Rennes University Hospital, Rennes, France
| | - Laure Farnault
- Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Laure Jullié
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Julien Haroche
- Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthew Collin
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | | | - Majid Madni
- Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Susan Picton
- Department of Pediatric Oncology, Leeds Children's Hospital, Leeds, United Kingdom
| | - Pasquale M Barbaro
- Department of Hematology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Alysa Poulin
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ingrid S Tam
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brianna Empringham
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James A Whitlock
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Amy A Swanson
- Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Jon M Brandt
- Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children's Hospital, Green Bay, WI
| | - Nabeel R Yaseen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joanna L Weinstein
- Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Irem Eldem
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Bryan A Sisk
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Vaishnavi Sridhar
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Mandy Atkinson
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, and
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sanda Alexandrescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
| | | | - Stephen Z Peeke
- Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY
| | - Laura S Muñoz-Arcos
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel G Leino
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David D Grier
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Lorsbach
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Somak Roy
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Ashish R Kumar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | | | - Michael M Henry
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ
| | - Astrid G S van Halteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Oussama Abla
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| |
Collapse
|
16
|
Osmanovic A, Gogol I, Martens H, Widjaja M, Müller K, Schreiber-Katz O, Feuerhake F, Langhans CD, Schmidt G, Andersen PM, Ludolph AC, Weishaupt JH, Brand F, Petri S, Weber RG. Heterozygous DHTKD1 Variants in Two European Cohorts of Amyotrophic Lateral Sclerosis Patients. Genes (Basel) 2021; 13:genes13010084. [PMID: 35052424 PMCID: PMC8774751 DOI: 10.3390/genes13010084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/26/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive upper and lower motor neuron (LMN) loss. As ALS and other neurodegenerative diseases share genetic risk factors, we performed whole-exome sequencing in ALS patients focusing our analysis on genes implicated in neurodegeneration. Thus, variants in the DHTKD1 gene encoding dehydrogenase E1 and transketolase domain containing 1 previously linked to 2-aminoadipic and 2-oxoadipic aciduria, Charcot-Marie-Tooth (CMT) disease type 2, and spinal muscular atrophy (SMA) were identified. In two independent European ALS cohorts (n = 643 cases), 10 sporadic cases of 225 (4.4%) predominantly sporadic patients of cohort 1, and 12 familial ALS patients of 418 (2.9%) ALS families of cohort 2 harbored 14 different rare heterozygous DHTKD1 variants predicted to be deleterious. Four DHTKD1 variants were previously described pathogenic variants, seven were recurrent, and eight were located in the E1_dh dehydrogenase domain. Nonsense variants located in the E1_dh domain were significantly more prevalent in ALS patients versus controls. The phenotype of ALS patients carrying DHTKD1 variants partially overlapped with CMT and SMA by presence of sensory impairment and a higher frequency of LMN-predominant cases. Our results argue towards rare heterozygous DHTKD1 variants as potential contributors to ALS phenotype and, possibly, pathogenesis.
Collapse
Affiliation(s)
- Alma Osmanovic
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, 45147 Essen, Germany
| | - Isabel Gogol
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Helge Martens
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Maylin Widjaja
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Kathrin Müller
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
| | | | - Friedrich Feuerhake
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany;
| | - Claus-Dieter Langhans
- GCMS Laboratory, Dietmar Hopp Metabolic Center, University Children’s Hospital, 69120 Heidelberg, Germany;
| | - Gunnar Schmidt
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Peter M. Andersen
- Department of Clinical Sciences, Neurosciences, Umeå University, 90185 Umeå, Sweden;
| | - Albert C. Ludolph
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
| | - Jochen H. Weishaupt
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
- Division for Neurodegenerative Diseases, Department of Neurology, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Frank Brand
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
- Correspondence: (S.P.); (R.G.W.)
| | - Ruthild G. Weber
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Correspondence: (S.P.); (R.G.W.)
| |
Collapse
|
17
|
Merveille O, Lampert T, Schmitz J, Forestier G, Feuerhake F, Wemmert C. An automatic framework for fusing information from differently stained consecutive digital whole slide images: A case study in renal histology. Comput Methods Programs Biomed 2021; 208:106157. [PMID: 34091100 DOI: 10.1016/j.cmpb.2021.106157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This article presents an automatic image processing framework to extract quantitative high-level information describing the micro-environment of glomeruli in consecutive whole slide images (WSIs) processed with different staining modalities of patients with chronic kidney rejection after kidney transplantation. METHODS This four-step framework consists of: 1) approximate rigid registration, 2) cell and anatomical structure segmentation 3) fusion of information from different stainings using a newly developed registration algorithm 4) feature extraction. RESULTS Each step of the framework is validated independently both quantitatively and qualitatively by pathologists. An illustration of the different types of features that can be extracted is presented. CONCLUSION The proposed generic framework allows for the analysis of the micro-environment surrounding large structures that can be segmented (either manually or automatically). It is independent of the segmentation approach and is therefore applicable to a variety of biomedical research questions. SIGNIFICANCE Chronic tissue remodelling processes after kidney transplantation can result in interstitial fibrosis and tubular atrophy (IFTA) and glomerulosclerosis. This pipeline provides tools to quantitatively analyse, in the same spatial context, information from different consecutive WSIs and help researchers understand the complex underlying mechanisms leading to IFTA and glomerulosclerosis.
Collapse
Affiliation(s)
- Odyssee Merveille
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, F-69100, LYON, France.
| | - Thomas Lampert
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France
| | | | | | - Friedrich Feuerhake
- Institute of Pathology, Hannover Medical School, Germany; University Clinic, Freiburg, Germany
| | - Cédric Wemmert
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France
| |
Collapse
|
18
|
Hermsen M, Volk V, Bräsen JH, Geijs DJ, Gwinner W, Kers J, Linmans J, Schaadt NS, Schmitz J, Steenbergen EJ, Swiderska-Chadaj Z, Smeets B, Hilbrands LB, Feuerhake F, van der Laak JAWM. Quantitative assessment of inflammatory infiltrates in kidney transplant biopsies using multiplex tyramide signal amplification and deep learning. J Transl Med 2021; 101:970-982. [PMID: 34006891 PMCID: PMC8292146 DOI: 10.1038/s41374-021-00601-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022] Open
Abstract
Delayed graft function (DGF) is a strong risk factor for development of interstitial fibrosis and tubular atrophy (IFTA) in kidney transplants. Quantitative assessment of inflammatory infiltrates in kidney biopsies of DGF patients can reveal predictive markers for IFTA development. In this study, we combined multiplex tyramide signal amplification (mTSA) and convolutional neural networks (CNNs) to assess the inflammatory microenvironment in kidney biopsies of DGF patients (n = 22) taken at 6 weeks post-transplantation. Patients were stratified for IFTA development (<10% versus ≥10%) from 6 weeks to 6 months post-transplantation, based on histopathological assessment by three kidney pathologists. One mTSA panel was developed for visualization of capillaries, T- and B-lymphocytes and macrophages and a second mTSA panel for T-helper cell and macrophage subsets. The slides were multi spectrally imaged and custom-made python scripts enabled conversion to artificial brightfield whole-slide images (WSI). We used an existing CNN for the detection of lymphocytes with cytoplasmatic staining patterns in immunohistochemistry and developed two new CNNs for the detection of macrophages and nuclear-stained lymphocytes. F1-scores were 0.77 (nuclear-stained lymphocytes), 0.81 (cytoplasmatic-stained lymphocytes), and 0.82 (macrophages) on a test set of artificial brightfield WSI. The CNNs were used to detect inflammatory cells, after which we assessed the peritubular capillary extent, cell density, cell ratios, and cell distance in the two patient groups. In this cohort, distance of macrophages to other immune cells and peritubular capillary extent did not vary significantly at 6 weeks post-transplantation between patient groups. CD163+ cell density was higher in patients with ≥10% IFTA development 6 months post-transplantation (p < 0.05). CD3+CD8-/CD3+CD8+ ratios were higher in patients with <10% IFTA development (p < 0.05). We observed a high correlation between CD163+ and CD4+GATA3+ cell density (R = 0.74, p < 0.001). Our study demonstrates that CNNs can be used to leverage reliable, quantitative results from mTSA-stained, multi spectrally imaged slides of kidney transplant biopsies.
Collapse
Affiliation(s)
- Meyke Hermsen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Valery Volk
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Daan J Geijs
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wilfried Gwinner
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Jesper Kers
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Analytical Sciences Amsterdam (CASA), Van 't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, Amsterdam, The Netherlands
| | - Jasper Linmans
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nadine S Schaadt
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Eric J Steenbergen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Zaneta Swiderska-Chadaj
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
- Faculty of Electrical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Bart Smeets
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany
- Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Jeroen A W M van der Laak
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
| |
Collapse
|
19
|
Gburek-Augustat J, Schoene-Bake JC, Bültmann E, Haack T, Buchert R, Synofzik M, Biskup S, Feuerhake F, Sorge I, Hartmann H. Pitfalls in Genetic Diagnostics: Why Phenotyping is Essential. Neuropediatrics 2021; 52:274-283. [PMID: 33791999 DOI: 10.1055/s-0041-1726306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
New genetic testing technologies have revolutionized medicine within the past years. It is foreseeable that the development will continue with the introduction of new techniques. Nevertheless, despite improved technology, an exact clinical description of the phenotype is still necessary and it is important to critically question findings, both before initiating genetic testing and when interpreting the results. We present four brief case vignettes to point out difficulties associated with correctly interpreting genetic findings.
Collapse
Affiliation(s)
- Janina Gburek-Augustat
- Division of Neuropediatrics, University Hospital, Hospital for Children and Adolescents, Leipzig, Germany.,Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.,Department of Neuropediatrics, Developmental Neurology, Social Paediatrics, University Children's Hospital Tuebingen, Tuebingen, Germany
| | - Jan-Christoph Schoene-Bake
- Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.,Gemeinschaftspraxis fuer Humangenetik, Hamburg, Germany
| | - Eva Bültmann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Tobias Haack
- Department of Medical Genetics and Applied Genomics, Rare Disease Center Tübingen, University of Tübingen, Tübingen, Germany
| | - Rebecca Buchert
- Department of Medical Genetics and Applied Genomics, Rare Disease Center Tübingen, University of Tübingen, Tübingen, Germany
| | - Matthis Synofzik
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Saskia Biskup
- CeGaT GmbH, Center for Genomics and Transcriptomics, Tübingen, Germany
| | | | - Ina Sorge
- Department of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Hans Hartmann
- Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| |
Collapse
|
20
|
Schreiber S, Aden K, Bernardes JP, Conrad C, Tran F, Höper H, Volk V, Mishra N, Blase JI, Nikolaus S, Bethge J, Kühbacher T, Röcken C, Chen M, Cottingham I, Petri N, Rasmussen BB, Lokau J, Lenk L, Garbers C, Feuerhake F, Rose-John S, Waetzig GH, Rosenstiel P. Therapeutic Interleukin-6 Trans-signaling Inhibition by Olamkicept (sgp130Fc) in Patients With Active Inflammatory Bowel Disease. Gastroenterology 2021; 160:2354-2366.e11. [PMID: 33667488 DOI: 10.1053/j.gastro.2021.02.062] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS A large unmet therapeutic need exists in inflammatory bowel disease (IBD). Inhibition of interleukin (IL)-6 appears to be effective, but the therapeutic benefit of a complete IL6/IL6 receptor (IL6R) blockade is limited by profound immunosuppression. Evidence has emerged that chronic proinflammatory activity of IL6 is mainly mediated by trans-signaling via a complex of IL6 bound to soluble IL6R engaging the gp130 co-receptor without the need for membrane-bound IL6R. We have developed a decoy protein, sgp130Fc, that exclusively blocks IL6 proinflammatory trans-signaling and has shown efficacy in preclinical models of IBD, without signs of immunosuppression. METHODS We present a 12-week, open-label, prospective phase 2a trial (FUTURE) in 16 patients with active IBD treated with the trans-signaling inhibitor olamkicept (sgp130Fc) to assess the molecular mechanisms, safety, and effectiveness of IL6 trans-signaling blockade in vivo. We performed in-depth molecular profiling at various timepoints before and after therapy induction to identify the mechanism of action of olamkicept. RESULTS Olamkicept was well tolerated and induced clinical response in 44% and clinical remission in 19% of patients. Clinical effectiveness coincided with target inhibition (reduction of phosphorylated STAT3) and marked transcriptional changes in the inflamed mucosa. An olamkicept-specific transcriptional signature, distinguishable from remission signatures of anti-tumor necrosis factor (infliximab) or anti-integrin (vedolizumab) therapies was identified. CONCLUSIONS Our data suggest that blockade of IL6 trans-signaling holds great promise for the therapy of IBD and should undergo full clinical development as a new immunoregulatory therapy for IBD. (EudraCT no., Nu 2016-000205-36).
Collapse
Affiliation(s)
- Stefan Schreiber
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - Konrad Aden
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Joana P Bernardes
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claudio Conrad
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Florian Tran
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hanna Höper
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Valery Volk
- Institute for Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Neha Mishra
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johanna Ira Blase
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanna Nikolaus
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johannes Bethge
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Christoph Röcken
- Department of Pathology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Minhu Chen
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | | | - Niclas Petri
- Ferring Pharmaceuticals A/S, Copenhagen S, Denmark
| | | | - Juliane Lokau
- Department of Pathology, Otto-von-Guericke-University Magdeburg, Medical Faculty, Magdeburg, Germany
| | - Lennart Lenk
- Department of Pediatrics I, Christian-Albrechts University Kiel and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Garbers
- Department of Pathology, Otto-von-Guericke-University Magdeburg, Medical Faculty, Magdeburg, Germany
| | - Friedrich Feuerhake
- Institute for Pathology, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Georg H Waetzig
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Conaris Research Institute AG, Kiel, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| |
Collapse
|
21
|
Graeser M, Feuerhake F, Gluz O, Volk V, Hauptmann M, Jozwiak K, Christgen M, Kuemmel S, Grischke EM, Forstbauer H, Braun M, Warm M, Hackmann J, Uleer C, Aktas B, Schumacher C, Kolberg-Liedtke C, Kates R, Wuerstlein R, Nitz U, Kreipe HH, Harbeck N. Immune cell composition and functional marker dynamics from multiplexed immunohistochemistry to predict response to neoadjuvant chemotherapy in the WSG-ADAPT-TN trial. J Immunother Cancer 2021; 9:e002198. [PMID: 33963012 PMCID: PMC8108653 DOI: 10.1136/jitc-2020-002198] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The association of early changes in the immune infiltrate during neoadjuvant chemotherapy (NACT) with pathological complete response (pCR) in triple-negative breast cancer (TNBC) remains unexplored. METHODS Multiplexed immunohistochemistry was performed in matched tumor biopsies obtained at baseline and after 3 weeks of NACT from 66 patients from the West German Study Group Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer - Triple Negative Breast Cancer (WSG-ADAPT-TN) trial. Association between CD4, CD8, CD73, T cells, PD1-positive CD4 and CD8 cells, and PDL1 levels in stroma and/or tumor at baseline, week 3 and 3-week change with pCR was evaluated with univariable logistic regression. RESULTS Compared with no change in immune cell composition and functional markers, transition from 'cold' to 'hot' (below-median and above-median marker level at baseline, respectively) suggested higher pCR rates for PD1-positive CD4 (tumor: OR=1.55, 95% CI 0.45 to 5.42; stroma: OR=2.65, 95% CI 0.65 to 10.71) and PD1-positive CD8 infiltrates (tumor: OR=1.77, 95% CI 0.60 to 5.20; stroma: OR=1.25, 95% CI 0.41 to 3.84; tumor+stroma: OR=1.62, 95% CI 0.51 to 5.12). No pCR was observed after 'hot-to-cold' transition in PD1-positive CD8 cells. pCR rates appeared lower after hot-to-cold transitions in T cells (tumor: OR=0.26, 95% CI 0.03 to 2.34; stroma: OR=0.35, 95% CI 0.04 to 3.25; tumor+stroma: OR=0.00, 95% CI 0.00 to 1.04) and PD1-positive CD4 cells (tumor: OR=0.60, 95% CI 0.11 to 3.35; stroma: OR=0.22, 95% CI 0.03 to 1.92; tumor+stroma: OR=0.32, 95% CI 0.04 to 2.94). Higher pCR rates collated with 'altered' distribution (levels below-median and above-median in tumor and stroma, respectively) of T cell (OR=3.50, 95% CI 0.84 to 14.56) and PD1-positive CD4 cells (OR=4.50, 95% CI 1.01 to 20.14). CONCLUSION Our exploratory findings indicate that comprehensive analysis of early immune infiltrate dynamics complements currently investigated predictive markers for pCR and may have a potential to improve guidance for individualized de-escalation/escalation strategies in TNBC.
Collapse
Affiliation(s)
- Monika Graeser
- West German Study Group, Moenchengladbach, Germany
- Breast Center Niederrhein, Bethesda Protestant Hospital Monchengladbach, Monchengladbach, Germany
- Department of Gynecology, University Medical Center Hamburg, Hamburg, Germany
| | - Friedrich Feuerhake
- Institute of Pathology, Medical School Hannover, Hannover, Germany
- Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany
- Breast Center Niederrhein, Bethesda Protestant Hospital Monchengladbach, Monchengladbach, Germany
- University Clinics Cologne, Cologne, Germany
| | - Valery Volk
- Institute of Pathology, Medical School Hannover, Hannover, Germany
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Katarzyna Jozwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | | | - Sherko Kuemmel
- West German Study Group, Moenchengladbach, Germany
- Breast Unit, Kliniken Essen-Mitte, Essen, Germany
- University Hospital Charité, Humboldt University, Berlin, Germany
| | | | | | - Michael Braun
- Breast Center, Rotkreuz Clinics Munich, Munich, Germany
| | - Mathias Warm
- Breast Center, City Hospital Holweide, Cologne, Germany
| | | | | | - Bahriye Aktas
- Women's Clinic, University Clinics Essen, Essen, Germany
- Women's Clinic, University Clinics Leipzig, Leipzig, Germany
| | | | - Cornelia Kolberg-Liedtke
- University Hospital Charité, Humboldt University, Berlin, Germany
- Women's Clinic, University Clinics Essen, Essen, Germany
| | - Ronald Kates
- West German Study Group, Moenchengladbach, Germany
| | - Rachel Wuerstlein
- West German Study Group, Moenchengladbach, Germany
- Breast Center, Department of Gynecology and Obstetrics and CCCLMU, LMU University Hospital, Munich, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany
- Breast Center Niederrhein, Bethesda Protestant Hospital Monchengladbach, Monchengladbach, Germany
| | | | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany
- Breast Center, Department of Gynecology and Obstetrics and CCCLMU, LMU University Hospital, Munich, Germany
| |
Collapse
|
22
|
Wirsik NM, Ehlers J, Mäder L, Ilina EI, Blank AE, Grote A, Feuerhake F, Baumgarten P, Devraj K, Harter PN, Mittelbronn M, Naumann U. TGF-β activates pericytes via induction of the epithelial-to-mesenchymal transition protein SLUG in glioblastoma. Neuropathol Appl Neurobiol 2021; 47:768-780. [PMID: 33780024 DOI: 10.1111/nan.12714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/29/2020] [Revised: 01/22/2021] [Accepted: 03/13/2021] [Indexed: 12/19/2022]
Abstract
AIMS In primary central nervous system tumours, epithelial-to-mesenchymal transition (EMT) gene expression is associated with increased malignancy. However, it has also been shown that EMT factors in gliomas are almost exclusively expressed by glioma vessel-associated pericytes (GA-Peris). In this study, we aimed to identify the mechanism of EMT in GA-Peris and its impact on angiogenic processes. METHODS In glioma patients, vascular density and the expression of the pericytic markers platelet derived growth factor receptor (PDGFR)-β and smooth muscle actin (αSMA) were examined in relation to the expression of the EMT transcription factor SLUG and were correlated with survival of patients with glioblastoma (GBM). Functional mechanisms of SLUG regulation and the effects on primary human brain vascular pericytes (HBVP) were studied in vitro by measuring proliferation, cell motility and growth characteristics. RESULTS The number of PDGFR-β- and αSMA-positive pericytes did not change with increased malignancy nor showed an association with the survival of GBM patients. However, SLUG-expressing pericytes displayed considerable morphological changes in GBM-associated vessels, and TGF-β induced SLUG upregulation led to enhanced proliferation, motility and altered growth patterns in HBVP. Downregulation of SLUG or addition of a TGF-β antagonising antibody abolished these effects. CONCLUSIONS We provide evidence that in GA-Peris, elevated SLUG expression is mediated by TGF-β, a cytokine secreted by most glioma cells, indicating that the latter actively modulate neovascularisation not only by modulating endothelial cells, but also by influencing pericytes. This process might be responsible for the formation of an unstructured tumour vasculature as well as for the breakdown of the blood-brain barrier in GBM.
Collapse
Affiliation(s)
- Naita M Wirsik
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,General-, Visceral- and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Jakob Ehlers
- Laboratory of Molecular Neuro-Oncology, Department of Vascular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Lisa Mäder
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,Department of Neurology, Klinikum Darmstadt, Darmstadt, Germany
| | - Elena I Ilina
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg.,Department of Oncology (DONC), Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
| | - Anna-Eva Blank
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,Pediatric Cardiology, University Hospital of Giessen, Gießen, Germany
| | - Anne Grote
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany.,Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Peter Baumgarten
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,Department of Neurosurgery, Goethe University, Frankfurt/Main, Germany
| | - Kavi Devraj
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Patrick N Harter
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Michel Mittelbronn
- Edinger Institute (Neurological Institute), Goethe University Hospital, Frankfurt/Main, Germany.,Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg.,Department of Oncology (DONC), Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg.,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg, Luxembourg.,National Center of Pathology (NCP), Laboratoire Nationale de Santé (LNS), Luxembourg, Luxembourg
| | - Ulrike Naumann
- Laboratory of Molecular Neuro-Oncology, Department of Vascular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| |
Collapse
|
23
|
Volk V, Theobald SJ, Danisch S, Khailaie S, Kalbarczyk M, Schneider A, Bialek-Waldmann J, Krönke N, Deng Y, Eiz-Vesper B, Dragon AC, von Kaisenberg C, Lienenklaus S, Bleich A, Keck J, Meyer-Hermann M, Klawonn F, Hammerschmidt W, Delecluse HJ, Münz C, Feuerhake F, Stripecke R. PD-1 Blockade Aggravates Epstein-Barr Virus + Post-Transplant Lymphoproliferative Disorder in Humanized Mice Resulting in Central Nervous System Involvement and CD4 + T Cell Dysregulations. Front Oncol 2021; 10:614876. [PMID: 33511078 PMCID: PMC7837057 DOI: 10.3389/fonc.2020.614876] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 10/07/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022] Open
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is one of the most common malignancies after solid organ or allogeneic stem cell transplantation. Most PTLD cases are B cell neoplasias carrying Epstein-Barr virus (EBV). A therapeutic approach is reduction of immunosuppression to allow T cells to develop and combat EBV. If this is not effective, approaches include immunotherapies such as monoclonal antibodies targeting CD20 and adoptive T cells. Immune checkpoint inhibition (ICI) to treat EBV+ PTLD was not established clinically due to the risks of organ rejection and graft-versus-host disease. Previously, blockade of the programmed death receptor (PD)-1 by a monoclonal antibody (mAb) during ex vivo infection of mononuclear cells with the EBV/M81+ strain showed lower xenografted lymphoma development in mice. Subsequently, fully humanized mice infected with the EBV/B95-8 strain and treated in vivo with a PD-1 blocking mAb showed aggravation of PTLD and lymphoma development. Here, we evaluated vis-a-vis in fully humanized mice after EBV/B95-8 or EBV/M81 infections the effects of a clinically used PD-1 blocker. Fifteen to 17 weeks after human CD34+ stem cell transplantation, Nod.Rag.Gamma mice were infected with two types of EBV laboratory strains expressing firefly luciferase. Dynamic optical imaging analyses showed systemic EBV infections and this triggered vigorous human CD8+ T cell expansion. Pembrolizumab administered from 2 to 5 weeks post-infections significantly aggravated EBV systemic spread and, for the M81 model, significantly increased the mortality of mice. ICI promoted Ki67+CD30+CD20+EBER+PD-L1+ PTLD with central nervous system (CNS) involvement, mirroring EBV+ CNS PTLD in humans. PD-1 blockade was associated with lower frequencies of circulating T cells in blood and with a profound collapse of CD4+ T cells in lymphatic tissues. Mice treated with pembrolizumab showed an escalation of exhausted T cells expressing TIM-3, and LAG-3 in tissues, higher levels of several human cytokines in plasma and high densities of FoxP3+ regulatory CD4+ and CD8+ T cells in the tumor microenvironment. We conclude that PD-1 blockade during acute EBV infections driving strong CD8+ T cell priming decompensates T cell development towards immunosuppression. Given the variety of preclinical models available, our models conferred a cautionary note indicating that PD-1 blockade aggravated the progression of EBV+ PTLD.
Collapse
Affiliation(s)
- Valery Volk
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover, Hannover, Germany.,Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Sebastian J Theobald
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover, Hannover, Germany
| | - Simon Danisch
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover, Hannover, Germany
| | - Sahamoddin Khailaie
- Department of Systems Immunology, Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Maja Kalbarczyk
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover, Hannover, Germany
| | - Andreas Schneider
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Julia Bialek-Waldmann
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Nicole Krönke
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Yun Deng
- Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
| | - Britta Eiz-Vesper
- Institute for Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Anna Christina Dragon
- Institute for Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Stefan Lienenklaus
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Andre Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - James Keck
- The Jackson Laboratory, Sacramento, CA, United States
| | - Michael Meyer-Hermann
- Department of Systems Immunology, Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Frank Klawonn
- Biostatistics Group, Helmholtz Centre for Infection Research, Braunschweig, Germany.,Institute for Information Engineering, Ostfalia University, Wolfenbuettel, Germany
| | - Wolfgang Hammerschmidt
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research (DZIF), Partner site Munich, Munich, Germany
| | - Henri-Jacques Delecluse
- German Cancer Research Center (DKFZ), Institut National de la Santé et de la Recherche Médicale (INSERM) Unit U1074, Heidelberg, Germany
| | - Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany.,Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Renata Stripecke
- Laboratory of Regenerative Immune Therapies Applied, REBIRTH - Research Center for Translational Regenerative Medicine, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover, Hannover, Germany
| |
Collapse
|
24
|
Nunan R, Oswald E, Aylott I, Feuerhake F, Jenkinson R, Schüler J. Abstract 2229: A panel of NSCLC patient derived xenografts displays a distinct sensitivity profile towards checkpoint inhibitor treatment in vitro and in vivo. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2229] [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
The field of cancer immunology is rapidly moving towards innovative therapeutic strategies. As a consequence there is a need for robust and predictive preclinical platforms for assessing therapies. The current project aims to establish a drug screening workflow bridging between innovative 3D in vitro assays and humanized mouse models based on the same PDX model panel. A total of six different lung cancer patient derived xenograft models (NSCLC PDX) were transduced to express nuclear RFP, cultivated as 3D spheroids and co-cultured with human peripheral blood monocytes (PBMC). Spheroid fluorescent intensity was monitored every 4 hours over a total of 120h. Efficacy of different checkpoint inhibitors was determined using a live cell imaging technology (IncuCyte S3, Sartorius). In vivo a total of 14 different NSCLC PDX were screened for their sensitivity towards α-CTLA-4, α-PD-1 or the combination thereof. With n=1 per treatment arm and model and the study design followed the screening approach of the single mouse trial (SMT). Human immune cell infiltrates of tumor (=TILs), peripheral blood, spleen and bone marrow (determined by flow cytometry, FC, and IHC) and secretion of human and mouse cytokines in murine serum (determined by cytokine array & Luminex based technology) were determined in all models.In the spheroid assay as well as in vivo all three treatment arms displayed a discrete activity pattern throughout the PDX panel. The activity pattern of the 14 PDX mirrored the clinical diversity of tumor responses to checkpoint inhibitor treatment ranging from complete remission to resistance. The sensitivity towards checkpoint inhibitors was stable in a distinct PDX model across the two drug development platforms. Tumor models with high tumor infiltrating lymphocyte (TIL) rates (>5%) in the untreated control group were more susceptible towards checkpoint inhibitor treatment than models with low TIL rates. In either case, numbers of TILs were markedly increased in the treatment groups as compared to control vehicle. The analysis of human and mouse cytokines in the serum of tumor bearing mice led to the identification of a cytokine pattern specific for PDX models sensitive towards checkpoint inhibitor treatment. 11 human cytokines were upregulated in the sensitive tumor models (e.g. GM-CSF, IL-4 & CX3CL1). The use of PDX based innovative 3D in vitro models in combination with humanized mouse models enables screening campaigns in the immune-oncology field using clinically relevant tumor models. The predictivity of the 3D spheroid platform towards the in vivo humanized mouse assay is a critical feature as it allows the optimal selection of promising drug candidates to be profiled in more detail.
Citation Format: Robert Nunan, Eva Oswald, Ilona Aylott, Friedrich Feuerhake, Rhiannon Jenkinson, Julia Schüler. A panel of NSCLC patient derived xenografts displays a distinct sensitivity profile towards checkpoint inhibitor treatment in vitro and in vivo [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2229.
Collapse
Affiliation(s)
- Robert Nunan
- 1Charles River Laboratories, Inc., Portishead, United Kingdom
| | - Eva Oswald
- 2Charles River Laboratories, Inc., Freiburg, Germany
| | - Ilona Aylott
- 1Charles River Laboratories, Inc., Portishead, United Kingdom
| | | | | | - Julia Schüler
- 2Charles River Laboratories, Inc., Freiburg, Germany
| |
Collapse
|
25
|
Slabik C, Kalbarczyk M, Danisch S, Zeidler R, Klawonn F, Volk V, Krönke N, Feuerhake F, Ferreira de Figueiredo C, Blasczyk R, Olbrich H, Theobald SJ, Schneider A, Ganser A, von Kaisenberg C, Lienenklaus S, Bleich A, Hammerschmidt W, Stripecke R. CAR-T Cells Targeting Epstein-Barr Virus gp350 Validated in a Humanized Mouse Model of EBV Infection and Lymphoproliferative Disease. Mol Ther Oncolytics 2020; 18:504-524. [PMID: 32953984 PMCID: PMC7479496 DOI: 10.1016/j.omto.2020.08.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023]
Abstract
Epstein-Barr virus (EBV) is a latent and oncogenic human herpesvirus. Lytic viral protein expression plays an important role in EBV-associated malignancies. The EBV envelope glycoprotein 350 (gp350) is expressed abundantly during EBV lytic reactivation and sporadically on the surface of latently infected cells. Here we tested T cells expressing gp350-specific chimeric antigen receptors (CARs) containing scFvs derived from two novel gp350-binding, highly neutralizing monoclonal antibodies. The scFvs were fused to CD28/CD3ζ signaling domains in a retroviral vector. The produced gp350CAR-T cells specifically recognized and killed gp350+ 293T cells in vitro. The best-performing 7A1-gp350CAR-T cells were cytotoxic against the EBV+ B95-8 cell line, showing selectivity against gp350+ cells. Fully humanized Nod.Rag.Gamma mice transplanted with cord blood CD34+ cells and infected with the EBV/M81/fLuc lytic strain were monitored dynamically for viral spread. Infected mice recapitulated EBV-induced lymphoproliferation, tumor development, and systemic inflammation. We tested adoptive transfer of autologous CD8+gp350CAR-T cells administered protectively or therapeutically. After gp350CAR-T cell therapy, 75% of mice controlled or reduced EBV spread and showed lower frequencies of EBER+ B cell malignant lymphoproliferation, lack of tumor development, and reduced inflammation. In summary, CD8+gp350CAR-T cells showed proof-of-concept preclinical efficacy against impending EBV+ lymphoproliferation and lymphomagenesis.
Collapse
Affiliation(s)
- Constanze Slabik
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Maja Kalbarczyk
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Simon Danisch
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Reinhard Zeidler
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health, 81377 Munich, Germany.,Department of Otorhinolaryngology, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany.,German Centre for Infection Research (DZIF), Partner Site Munich, 81377 Munich, Germany
| | - Frank Klawonn
- Biostatistics Group, Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany.,Institute for Information Engineering, Ostfalia University, 38302 Wolfenbuettel, Germany
| | - Valery Volk
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany.,Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany
| | - Nicole Krönke
- Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany
| | - Friedrich Feuerhake
- Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany.,Institute for Neuropathology, University Clinic Freiburg, 79106 Freiburg, Germany
| | | | - Rainer Blasczyk
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, 30625 Hannover, Germany
| | - Henning Olbrich
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Sebastian J Theobald
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Andreas Schneider
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Stefan Lienenklaus
- Institute for Laboratory Animal Science, Hannover Medical School, 30625 Hannover, Germany
| | - Andre Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, 30625 Hannover, Germany
| | - Wolfgang Hammerschmidt
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health, 81377 Munich, Germany.,German Centre for Infection Research (DZIF), Partner Site Munich, 81377 Munich, Germany
| | - Renata Stripecke
- Laboratory of Regenerative Immune Therapies Applied, Hannover Medical School, 30625 Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover, 30625 Hannover, Germany
| |
Collapse
|
26
|
Kolberg-Liedtke C, Gluz O, Heinisch F, Feuerhake F, Kreipe H, Clemens M, Nuding B, Malter W, Reimer T, Wuerstlein R, Graeser M, Shak S, Nitz U, Kates R, Christgen M, Harbeck N. Association of TILs with clinical parameters, Recurrence Score® results, and prognosis in patients with early HER2-negative breast cancer (BC)-a translational analysis of the prospective WSG PlanB trial. Breast Cancer Res 2020; 22:47. [PMID: 32408905 PMCID: PMC7227091 DOI: 10.1186/s13058-020-01283-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/09/2019] [Accepted: 04/24/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The presence of tumor-infiltrating lymphocytes has been associated with prognosis and chemotherapy response, particularly in high-risk breast cancer subtypes. There is limited data so far as to (i) how tumor-infiltrating lymphocyte (TIL) measurements correlate with genomic measurements such as the Oncotype DX Recurrence Score® and (ii) whether the survival impact of TIL measurements varies according to different adjuvant systemic therapies. METHODS The WSG PlanB trial compared an anthracycline-free chemotherapy regimen (6x docetaxel/cyclophosphamide, TC) to an anthracycline-taxane sequence (4xEC followed by 4x docetaxel) in patients with intermediate-risk, HER2-negative early breast cancer (EBC). Patients with HR-positive HER2-negative EBC were further stratified to receive endocrine therapy alone vs. chemotherapy followed by endocrine therapy based on Recurrence Score results and nodal status. In this analysis, three independent observers quantified and categorized the presence of TILs among tumor samples from patients in PlanB. TIL measurements were correlated with clinical/pathological parameters and treatment outcome overall and according to the treatment arm. RESULTS Disease-free survival (DFS) rates were significantly better (p = .04) in HR-negative patients with high vs. intermediate TIL levels and were higher in low vs. intermediate TIL patients, however with borderline significance only (p = .06). There were no significant differences among TIL categories in HR+ patients. High RS categories, HR-negative status, and high KI67 were independently and significantly associated with high TIL categories. There was no significant impact of TIL category on DFS in patients treated by endocrine therapy only; however, in patients receiving chemotherapy, DFS in the intermediate TIL category was lower than that in the other categories. CONCLUSION Although the presence of high TILs is associated with negative prognostic parameters such as high KI67 and HR-negative status among patients with HR-positive HER2-negative EBC, patients with high TILs show a favorable 5-year DFS in both HR-positive/HER2-negative and triple-negative breast cancer.
Collapse
Affiliation(s)
| | - Oleg Gluz
- West German Study Group, Mönchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Fred Heinisch
- Institute of Pathology, Medical School Hannover, Hannover, Germany
| | - Friedrich Feuerhake
- Department of Oncology, Clinics Mutterhaus der Borromaeerinnen, Trier, Germany
| | - Hans Kreipe
- Department of Oncology, Clinics Mutterhaus der Borromaeerinnen, Trier, Germany
| | - Michael Clemens
- Department of Gynecology and Obstetrics, Evangelical Hospital, Bergisch Gladbach, Germany
| | - Benno Nuding
- Department of Gynaecology and Obstertrics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Wolfram Malter
- Department of Gynaecology and Obstetrics, University Clinics Rostock, Rostock, Germany
| | - Toralf Reimer
- Breast Center, Department of Gynecology and Obstetrics, University of Munich (LMU) and CCCLMU, Munich, Germany
| | - Rachel Wuerstlein
- West German Study Group, Mönchengladbach, Germany.,Genomic Health, Inc., Redwood City, CA, USA
| | - Monika Graeser
- West German Study Group, Mönchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Steve Shak
- Genomic Health, Inc., Redwood City, CA, USA
| | - Ulrike Nitz
- West German Study Group, Mönchengladbach, Germany.,Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany
| | - Ronald Kates
- West German Study Group, Mönchengladbach, Germany
| | - Matthias Christgen
- Department of Oncology, Clinics Mutterhaus der Borromaeerinnen, Trier, Germany
| | - Nadia Harbeck
- West German Study Group, Mönchengladbach, Germany.,Breast Center, Department of Gynecology and Obstetrics, University of Munich (LMU) and CCCLMU, Munich, Germany
| |
Collapse
|
27
|
Gluz O, Kolberg-Liedtke C, Biehl C, Christgen M, Kuemmel S, Grischke EM, Augustin D, Braun M, Potenberg J, Graeser M, Kates R, Wuerstlein R, Feuerhake F, Nitz U, Kreipe H, Harbeck N, Group WGS. Abstract P4-10-05: Predictive value of HER2 expression, early response and tumor infiltrating lymphocytes (TILs) on efficacy of de-escalated pertuzumab+trastuzumab in the neoadjuvant WSG-ADAPT-HER2+/HR- trial. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p4-10-05] [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
Purpose: Only limited data are available on predictive markers for use of chemotherapy-free, anti-HER2 combinations in HER2-positive early breast cancer (eBC), in particular within the molecularly distinct HER2+/HR- subgroup.
Background: In the ADAPT HER2+/HR- trial, a promising pCR of about 43-45% was found in patients treated by 4 cycles of pertuzumab and trastuzumab with either defined early response (low tumor cellularity or relative Ki-67 decrease ≥30%) or indeterminate early response (e.g. no visible tumor by ultrasound), compared to under 10% in early non-responders. In addition to early response, HER2 protein expression and stromal TIL (s-TIL) dynamics after one cycle of therapy are promising tools for identification of patients with high likelihood of pathological complete response (pCR) after therapy with double anti-HER2 blockade (e.g. by lapatinib+trastuzumab) or T-DM1.
Methods: Patients with cT1-cT4c, cN0-3 early HER2+/HR- BC (n=134) were treated with 4 cycles of P+T +/- paclitaxel d1,8,15 q3w. Primary endpoint of the study was pCR (ypT0/is, ypN0). All tumors were HR-negative (ER and PR<1%) and locally HER2 positive, i.e., 2+ with positive FISH or 3+ by immunohistochemistry (IHC). HR and HER2 status were confirmed by central pathology prior to randomization.
Tumors were classified as “HER2-low” if HER2-1+ or HER2-2+ by either local or central IHC assessment, otherwise “HER2-high”. s-TILs were measured semi-quantitively according to current international consensus in triplicate at baseline and on-treatment (at cycle 2); the median of the three measurements was taken to define the quantities TIL-0 and TIL-3, respectively. “Lymphocyte-dominant subtype” at baseline and cycle 2 were defined as TIL-0≥40% and TIL-3≥40%, respectively.
The present analysis characterizes the predictive impact of early response HER2 protein expression, and s-TILs on pCR under dual anti-HER2 therapy for the first time within a prospective neoadjuvant trial specific to the HER2+/HR- BC subtype.
Results: As previously reported, pCR was 34.4% without chemotherapy and 90.5% with chemotherapy. TIL-0 and TIL-3 were available in n=119/134 and n=103/134 patients, respectively. TIL-0 and TIL-3 were not significantly associated with pCR in the whole cohort or within the T+P arm, either modeled as a continuous variable or in terms of binary variables representing lymphocyte-dominant subtype or defined by the respective population medians.
HER2-high expression was found in 87% of patients. In the T+P arm, pCR was much higher in HER2-high than HER2-low patients (40.3% vs. 0%, p=.003).
In the T+P arm, 24 and 38 of 92 patients were classified as non- and responders, unclassified early response was observed in 30 of 92 patients. pCR in these groups were 8.3% vs. 44.7% vs. 42.9% respectively. Higher baseline TILs were positively associated with early response.
Clinically meaningful pCR of 49% after only 4 cycles of chemotherapy-free P+T was seen in those patients with early response after one cycle of therapy and HER2-high classification, compared to 11.8% in the HER2-high/non-responder group).
Conclusions: At present, a combination of baseline high HER2 expression with low cellularity after one cycle of neoadjuvant therapy – rather than s-TIL determination (at baseline or in response to therapy) – appears to be a simple and feasible tool for identification of candidates for de-escalated treatment in HER2+/HR- disease. Further research on high-precision determination of HER2-high expression (by immunohistochemistry vs. mRNA-based tools) is strongly needed for optimal patient selection for future chemotherapy de-escalation trials.
Citation Format: Oleg Gluz, Cornelia Kolberg-Liedtke, Claudia Biehl, Matthias Christgen, Sherko Kuemmel, Eva-Maria Grischke, Doris Augustin, Michael Braun, Jochem Potenberg, Monika Graeser, Ronald Kates, Rachel Wuerstlein, Friedrich Feuerhake, Ulrike Nitz, Hans Kreipe, Nadia Harbeck, West German Study Group. Predictive value of HER2 expression, early response and tumor infiltrating lymphocytes (TILs) on efficacy of de-escalated pertuzumab+trastuzumab in the neoadjuvant WSG-ADAPT-HER2+/HR- trial [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-10-05.
Collapse
Affiliation(s)
- Oleg Gluz
- 1West German Study Group and Breast Center Niederrhein Johanniter Clinics and University Clinics of Cologne, Moenchengladbach, Germany
| | | | - Claudia Biehl
- 3Westphalian Breast Center, City Hospital Dortmund, Dortmund, Germany
| | | | | | | | - Doris Augustin
- 7DONAUISAR Clinics Deggendorf, Breast Center Ostbayern, Deggendorf, Germany
| | - Michael Braun
- 8Breast Center, Rotkreuzklinikum Munich, Munich, Germany
| | - Jochem Potenberg
- 9Department of Oncology, Evangelical Waldkrankenhaus, Berlin, Germany
| | - Monika Graeser
- 10West German Study Group and Breast Center Niederrhein Johanniter Clinics, Moenchengladbach, Germany
| | - Ronald Kates
- 11West German Study Group, Moenchengladbach, Germany
| | - Rachel Wuerstlein
- 12Breast Center, University of Munich (LMU) and CCCLMU, München, Germany
| | - Friedrich Feuerhake
- 13Medical School Hannover, Institute of Pathology, Moenchengladbach, Germany
| | - Ulrike Nitz
- 10West German Study Group and Breast Center Niederrhein Johanniter Clinics, Moenchengladbach, Germany
| | - Hans Kreipe
- 4Medical School Hannover, Institute of Pathology, Hannover, Germany
| | - Nadia Harbeck
- 14Breast Center, University of Munich (LMU) and CCCLMU, Munich, Germany
| | | |
Collapse
|
28
|
Schaadt NS, Schönmeyer R, Forestier G, Brieu N, Braubach P, Nekolla K, Meyer-Hermann M, Feuerhake F. Graph-based description of tertiary lymphoid organs at single-cell level. PLoS Comput Biol 2020; 16:e1007385. [PMID: 32084130 PMCID: PMC7055921 DOI: 10.1371/journal.pcbi.1007385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 03/04/2020] [Accepted: 09/09/2019] [Indexed: 01/17/2023] Open
Abstract
Our aim is to complement observer-dependent approaches of immune cell evaluation in microscopy images with reproducible measures for spatial composition of lymphocytic infiltrates. Analyzing such patterns of inflammation is becoming increasingly important for therapeutic decisions, for example in transplantation medicine or cancer immunology. We developed a graph-based assessment of lymphocyte clustering in full whole slide images. Based on cell coordinates detected in the full image, a Delaunay triangulation and distance criteria are used to build neighborhood graphs. The composition of nodes and edges are used for classification, e.g. using a support vector machine. We describe the variability of these infiltrates on CD3/CD20 duplex staining in renal biopsies of long-term functioning allografts, in breast cancer cases, and in lung tissue of cystic fibrosis patients. The assessment includes automated cell detection, identification of regions of interest, and classification of lymphocytic clusters according to their degree of organization. We propose a neighborhood feature which considers the occurrence of edges with a certain type in the graph to distinguish between phenotypically different immune infiltrates. Our work addresses a medical need and provides a scalable framework that can be easily adjusted to the requirements of different research questions.
Collapse
Affiliation(s)
| | | | | | | | - Peter Braubach
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Michael Meyer-Hermann
- Systems Immunology and Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Institute for Biochemistry, Biotechnology and Bioinformatics, TU Braunschweig, Braunschweig, Germany
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany
- Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| |
Collapse
|
29
|
Jang MS, Vijayan V, Feuerhake F, Rong S, Thorenz A, Kreimann K, Gwinner W, Meier M, Richter N, Grannas G, Khalifa AA, Haller H, Bräsen JH, Immenschuh S, Gueler F. SP714MIXED CELLULAR AND ANTIBODY MEDIATED REJECTION AFTER EXPERIMENTAL ALLOGENIC KIDNEY TRANSPLANTATION – TERTIARY LYMPHOID ORGAN FORMATION IN THE GRAFT. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - Song Rong
- Hannover Medical School, Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Grote A, Schaadt NS, Forestier G, Wemmert C, Feuerhake F. Crowdsourcing of Histological Image Labeling and Object Delineation by Medical Students. IEEE Trans Med Imaging 2019; 38:1284-1294. [PMID: 30489264 DOI: 10.1109/tmi.2018.2883237] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Crowdsourcing in pathology has been performed on tasks that are assumed to be manageable by nonexperts. Demand remains high for annotations of more complex elements in digital microscopic images, such as anatomical structures. Therefore, this paper investigates conditions to enable crowdsourced annotations of high-level image objects, a complex task considered to require expert knowledge. Seventy six medical students without specific domain knowledge who voluntarily participated in three experiments solved two relevant annotation tasks on histopathological images: 1) labeling of images showing tissue regions and 2) delineation of morphologically defined image objects. We focus on methods to ensure sufficient annotation quality including several tests on the required number of participants and on the correlation of participants' performance between tasks. In a set up simulating annotation of images with limited ground truth, we validated the feasibility of a confidence score using full ground truth. For this, we computed a majority vote using weighting factors based on individual assessment of contributors against scattered gold standard annotated by pathologists. In conclusion, we provide guidance for task design and quality control to enable a crowdsourced approach to obtain accurate annotations required in the era of digital pathology.
Collapse
|
31
|
Gluz O, Nitz U, Liedtke C, Prat A, Christgen M, Feuerhake F, Garke M, Grischke EM, Forstbauer H, Braun M, Warm M, Hackmann J, Uleer C, Aktas B, Schumacher C, Kuemmel S, Pelz E, Gebauer D, Paré L, Kates R, Wuerstlein R, Kreipe HH, Harbeck N. Abstract GS5-06: No survival benefit of chemotherapy escalation in patients with pCR and “high-immune” triple-negative early breast cancer in the neoadjuvant WSG-ADAPT-TN trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs5-06] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Immune markers such as tumor infiltrating lymphocytes (TILs), CD8, PDL1, PD1 and other protein or mRNA-based genomic markers have been identified as prognostic / predictive in TNBC regarding survival / chemotherapy (CTx) efficacy.
In the adjuvant WSG-PlanB trial, patients with high TILs and/or CD8 by mRNA had excellent outcome, irrespective of anthracycline use; in the neoadjuvant ADAPT-TN trial, high PDL1, PD1 and CD8 and/or TILs were predictive for pCR. Still, optimal markers for potential treatment de-escalation have yet to be determined. Here, we analyse for the first time impact of immune mRNA-based markers and TIL's as prognostic and predictive survival markers.
Methods: TNBC patients (ER/PR<1%, HER2-,) were randomized to neoadjuvant 4x nab-paclitaxel 125 mg/m2/gemcitabine 1000 mg/m2 d1/8 q3w (gem arm) or 4x nab-paclitaxel 125 mg/m2/carboplatin AUC2 day 1/8 3-weekly (q3w) (carbo arm). Primary endpoint of WSG-ADAPT-TN was pCR (ypT0/is/ypN0); secondary endpoints included translational analyses, e.g., TILs or expression of 119 genes by nCounter platform. Standard adjuvant chemotherapy (4xEC) was optional (not randomized) in patients achieving pCR after 12 weeks. According to protocol, 1st safety survival analysis was performed after 3y median follow-up.
Results: Present translational analysis included 306 of 336 TNBC patients (36 months median FU). pCR was associated with significantly better survival (3y EFS: 92% vs. 71%, p<.001), but despite substantially higher pCR in the carbo arm (46% vs. 29%), no significant EFS advantage was seen (p=.6) (gem: 78%; carbo: 80%; 3y-EFS).
Bivariate Spearman correlations among CD8, PD1, and PDL1 were strongly positive; their correlations with TILs were moderately positive.
Preliminary Cox analysis of EFS was performed with clinical variables (cN, cT, menopausal status); neoadjuvant study arm; pCR; TILs; proliferation markers (baseline Ki67 by IHC, scores derived from PAM50); baseline immune markers; risk scores; and individual gene expression scores previously identified as prognostic for pCR in one or both neoadjuvant arms. Independent prognostic factors included pCR, cN, Ki67, PD1, and CD8; these were entered into (prognostic) interaction analysis. The resulting model contained cN, high Ki67 and low TILs as (unfavorable) main effects and the interaction of (higher) PD1*pCR (favorable).
Among pCR patients, the groups with/without additional adjuvant CTX were similar with respect to explanatory factors. Baseline TILs, Ki67, cN, and PD1 were entered into exploratory predictive analysis; the model retained only the interaction [adjuvant CTx * (fractionally ranked) PD1]. In patients with pCR, those with low PD1 benefited from standard anthracycline-containing adjuvant CTx, whereas patients high PD1 did not with an 98% 3y-EFS.
Conclusions: Our exploratory results suggest independent prognostic impact of mRNA markers and TIL's in early TNBC. Patients with both pCR (after 12 weeks) and “high-immune” signature (defined here by PD1) had excellent 3y-EFS and may be candidates for treatment de-escalation (e.g. omission of anthracyclines), whereas “low-immune” pCR patients may benefit from standard adjuvant poly-chemotherapy.
Citation Format: Gluz O, Nitz U, Liedtke C, Prat A, Christgen M, Feuerhake F, Garke M, Grischke E-M, Forstbauer H, Braun M, Warm M, Hackmann J, Uleer C, Aktas B, Schumacher C, Kuemmel S, Pelz E, Gebauer D, Paré L, Kates R, Wuerstlein R, Kreipe HH, Harbeck N. No survival benefit of chemotherapy escalation in patients with pCR and “high-immune” triple-negative early breast cancer in the neoadjuvant WSG-ADAPT-TN trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS5-06.
Collapse
Affiliation(s)
- O Gluz
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - U Nitz
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - C Liedtke
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - A Prat
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - M Christgen
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - F Feuerhake
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - M Garke
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - E-M Grischke
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - H Forstbauer
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - M Braun
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - M Warm
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - J Hackmann
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - C Uleer
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - B Aktas
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - C Schumacher
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - S Kuemmel
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - E Pelz
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - D Gebauer
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - L Paré
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - R Kates
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - R Wuerstlein
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - HH Kreipe
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| | - N Harbeck
- West German Study Group, Moenchengladbach, Germany; Ev. Hospital Bethesda, Breast Center Niederrhein, Moenchengladbach, Germany; University Clinics Charité, Women's Clinic, Berlin, Germany; Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Hannover Medical School, Institute of Pathology, Hannover, Germany; University Hospital Luebeck, Luebeck, Germany; University Clinics Tuebingen, Women's Clinic, Tuebingen, Germany; Practice Network Troisdorf, Troisdorf, Germany; Rotkreuz Clinics Munich, Breast Center, Munich, Germany; City Hospital Holweide, Breast Center, Cologne, Germany; Marien Hospital, Breast Center, Witten, Germany; Practice of Gynecology and Oncology, Hildesheim, Germany; University Clinics Essen, Women's Clinic, Essen, Germany; University Clinics Leipzig, Women's Clinic, Leipzig, Germany; St. Elisabeth Hospital, Breast Center, Cologne, Germany; Clinics Essen
| |
Collapse
|
32
|
Zeiner PS, Preusse C, Golebiewska A, Zinke J, Iriondo A, Muller A, Kaoma T, Filipski K, Müller-Eschner M, Bernatz S, Blank AE, Baumgarten P, Ilina E, Grote A, Hansmann ML, Verhoff MA, Franz K, Feuerhake F, Steinbach JP, Wischhusen J, Stenzel W, Niclou SP, Harter PN, Mittelbronn M. Distribution and prognostic impact of microglia/macrophage subpopulations in gliomas. Brain Pathol 2019; 29:513-529. [PMID: 30506802 PMCID: PMC6849857 DOI: 10.1111/bpa.12690] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [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: 08/06/2018] [Accepted: 11/14/2018] [Indexed: 12/28/2022] Open
Abstract
While the central nervous system is considered an immunoprivileged site and brain tumors display immunosuppressive features, both innate and adaptive immune responses affect glioblastoma (GBM) growth and treatment resistance. However, the impact of the major immune cell population in gliomas, represented by glioma‐associated microglia/macrophages (GAMs), on patients’ clinical course is still unclear. Thus, we aimed at assessing the immunohistochemical expression of selected microglia and macrophage markers in 344 gliomas (including gliomas from WHO grade I–IV). Furthermore, we analyzed a cohort of 241 IDH1R132H‐non‐mutant GBM patients for association of GAM subtypes and patient overall survival. Phenotypical properties of GAMs, isolated from high‐grade astrocytomas by CD11b‐based magnetic cell sorting, were analyzed by immunocytochemistry, mRNA microarray, qRT‐PCR and bioinformatic analyses. A higher amount of CD68‐, CD163‐ and CD206‐positive GAMs in the vital tumor core was associated with beneficial patient survival. The mRNA expression profile of GAMs displayed an upregulation of factors that are considered as pro‐inflammatory M1 (eg, CCL2, CCL3L3, CCL4, PTGS2) and anti‐inflammatory M2 polarization markers (eg, MRC1, LGMN, CD163, IL10, MSR1), the latter rather being associated with phagocytic functions in the GBM microenvironment. In summary, we present evidence that human GBMs contain mixed M1/M2‐like polarized GAMs and that the levels of different GAM subpopulations in the tumor core are positively associated with overall survival of patients with IDH1R132H‐non‐mutant GBMs.
Collapse
Affiliation(s)
- Pia S Zeiner
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Dr. Senckenberg Institute of Neurooncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Corinna Preusse
- Department of Neuropathology, Charité Berlin, Berlin, Germany
| | - Anna Golebiewska
- NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg
| | - Jenny Zinke
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ane Iriondo
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Arnaud Muller
- Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg
| | - Tony Kaoma
- Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg
| | - Katharina Filipski
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Monika Müller-Eschner
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Simon Bernatz
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anna-Eva Blank
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Peter Baumgarten
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Elena Ilina
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg.,Luxembourg Centre of Neuropathology (LCNP), Luxembourg
| | - Anne Grote
- Institute of Pathology and Neuropathology, Medical University Hannover, Hannover, Germany
| | - Martin L Hansmann
- Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Marcel A Verhoff
- Institute of Legal Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Kea Franz
- Dr. Senckenberg Institute of Neurooncology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Friedrich Feuerhake
- Institute of Pathology and Neuropathology, Medical University Hannover, Hannover, Germany.,Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Joachim P Steinbach
- Dr. Senckenberg Institute of Neurooncology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg Wischhusen
- Department of Gynecology, University of Wuerzburg, Wuerzburg, Germany
| | - Werner Stenzel
- Department of Neuropathology, Charité Berlin, Berlin, Germany
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg.,KG Jebsen Brain Tumour Research Center, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Patrick N Harter
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michel Mittelbronn
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (LIH), Luxembourg.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Luxembourg Centre of Neuropathology (LCNP), Luxembourg.,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg.,Laboratoire national de santé (LNS), Dudelange, Luxembourg
| |
Collapse
|
33
|
Danisch S, Slabik C, Cornelius A, Albanese M, Tagawa T, Chen YFA, Krönke N, Eiz-Vesper B, Lienenklaus S, Bleich A, Theobald SJ, Schneider A, Ganser A, von Kaisenberg C, Zeidler R, Hammerschmidt W, Feuerhake F, Stripecke R. Spatiotemporally Skewed Activation of Programmed Cell Death Receptor 1-Positive T Cells after Epstein-Barr Virus Infection and Tumor Development in Long-Term Fully Humanized Mice. Am J Pathol 2018; 189:521-539. [PMID: 30593822 PMCID: PMC6902117 DOI: 10.1016/j.ajpath.2018.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/26/2018] [Accepted: 11/06/2018] [Indexed: 01/04/2023]
Abstract
Humanized mice developing functional human T cells endogenously and capable of recognizing cognate human leukocyte antigen–matched tumors are emerging as relevant models for studying human immuno-oncology in vivo. Herein, mice transplanted with human CD34+ stem cells and bearing endogenously developed human T cells for >15 weeks were infected with an oncogenic recombinant Epstein-Barr virus (EBV), encoding enhanced firefly luciferase and green fluorescent protein. EBV–firefly luciferase was detectable 1 week after infection by noninvasive optical imaging in the spleen, from where it spread rapidly and systemically. EBV infection resulted into a pronounced immunologic skewing regarding the expansion of CD8+ T cells in the blood outnumbering the CD4+ T and CD19+ B cells. Furthermore, within 10 weeks of infections, mice developing EBV-induced tumors had significantly higher absolute numbers of CD8+ T cells in lymphatic tissues than mice controlling tumor development. Tumor outgrowth was paralleled by an up-regulation of the programmed cell death receptor 1 on CD8+ and CD4+ T cells, indicative for T-cell dysfunction. Histopathological examinations and in situ hybridizations for EBV in tumors, spleen, liver, and kidney revealed foci of EBV-infected cells in perivascular regions in close association with programmed cell death receptor 1–positive infiltrating lymphocytes. The strong spatiotemporal correlation between tumor development and the T-cell dysfunctional status seen in this viral oncogenesis humanized model replicates observations obtained in the clinical setting.
Collapse
Affiliation(s)
- Simon Danisch
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany
| | - Constanze Slabik
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany
| | - Angela Cornelius
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany
| | - Manuel Albanese
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research, Partner Site Munich, Munich, Germany
| | - Takanobu Tagawa
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research, Partner Site Munich, Munich, Germany
| | - Yen-Fu A Chen
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research, Partner Site Munich, Munich, Germany
| | - Nicole Krönke
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Britta Eiz-Vesper
- Institutes for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | | | - Andre Bleich
- Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Sebastian J Theobald
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany
| | - Andreas Schneider
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Reinhard Zeidler
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research, Partner Site Munich, Munich, Germany; Department of Otorhinolaryngology, Klinikum der Universität and German Centre for Infection Research, Partner Site Munich, Munich, Germany
| | - Wolfgang Hammerschmidt
- Research Unit Gene Vectors, Helmholtz Zentrum München, German Research Center for Environmental Health and German Centre for Infection Research, Partner Site Munich, Munich, Germany
| | - Friedrich Feuerhake
- Institute of Pathology, Hannover Medical School, Hannover, Germany; Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Renata Stripecke
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Laboratory of Regenerative Immune Therapies Applied, Excellence Cluster REBIRTH and German Centre for Infection Research, Partner Site Hannover, Hannover, Germany.
| |
Collapse
|
34
|
Stoeckelhuber M, Feuerhake F, Schmitz C, Wolff KD, Kesting MR. Immunolocalization of Surfactant Proteins SP-A, SP-B, SP-C, and SP-D in Infantile Labial Glands and Mucosa. J Histochem Cytochem 2018; 66:531-538. [PMID: 29601229 PMCID: PMC6055263 DOI: 10.1369/0022155418766063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Surfactant proteins in different glandular structures of the oral cavity display antimicrobial activity for protection of invading microorganisms. Moreover, they are involved in lowering liquid tension in fluids and facilitate secretion flows. Numerous investigations for studying the occurrence of surfactant proteins in glandular tissues were performed using different methods. In the oral cavity, minor salivary glands secrete saliva continuously for the maintenance of a healthy oral environment. For the first time, we could show that infantile labial glands show expression of the surfactant proteins (SP) SP-A, SP-B, SP-C, and SP-D in acinar cells and the duct system in different intensities. The stratified squamous epithelium of the oral mucosa revealed positive staining for SPs in various cell layers.
Collapse
Affiliation(s)
- Mechthild Stoeckelhuber
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Munich, Germany
| | - Friedrich Feuerhake
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Christoph Schmitz
- Chair of Neuroanatomy, Institute of Anatomy, Faculty of Medicine, Ludwig Maximilians University of Munich, Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Munich, Germany
| | - Marco R. Kesting
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Munich, Germany
| |
Collapse
|
35
|
Liedtke C, Feuerhake F, Garke M, Christgen M, Kates RE, Grischke EM, Forstbauer H, Braun MW, Warm MR, Hackmann C, Uleer C, Aktas B, Schumacher C, Kummel S, Wuerstlein R, Nitz U, Kreipe HH, Gluz O, Harbeck N. Impact of tumor-infiltrating lymphocytes on response to neoadjuvant chemotherapy in triple-negative early breast cancer: Translational subproject of the WSG-ADAPT TN trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.12102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Eva-Maria Grischke
- Universitӓts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany
| | | | | | | | | | | | | | | | | | | | - Ulrike Nitz
- West German Study Group/ Breast Center Niederrhein, Moenchengladbach, Germany
| | | | - Oleg Gluz
- Breast Center Niederrhein and University Clinics Cologne, Moenchengladbach, Germany
| | - Nadia Harbeck
- Brustzentrum der Universität München (LMU), Munich, Germany
| |
Collapse
|
36
|
Christgen M, van Luttikhuizen JL, Raap M, Braubach P, Schmidt L, Jonigk D, Feuerhake F, Lehmann U, Schlegelberger B, Kreipe HH, Steinemann D. Precise ERBB2 copy number assessment in breast cancer by means of molecular inversion probe array analysis. Oncotarget 2018; 7:82733-82740. [PMID: 27716627 PMCID: PMC5347728 DOI: 10.18632/oncotarget.12421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 07/02/2016] [Accepted: 09/19/2016] [Indexed: 01/01/2023] Open
Abstract
HER2/ERBB2 amplification/overexpression determines the eligibility of breast cancer patients to HER2-targeted therapy. This study evaluates the agreement between ERBB2 copy number assessment by fluorescence in situ hybridization, a standard method recommended by the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP), and newly available DNA extraction-based methods. A series of n=29 formalin-fixed paraffin-embedded breast cancers were subjected to ERBB2 copy number assessment by fluorescence in situ hybridization (FISH, Vysis, Abbott). Following macrodissection of invasive breast cancer tissue and DNA extraction, ERBB2 copy number was also determined by molecular inversion probe array analysis (MIP, OncoScan, Affymetrix) and next generation sequencing combined with normalized amplicon coverage analysis (NGS/NAC, AmpliSeq, Ion Torrent). ERBB2 copy number values obtained by MIP or NGS/NAC were tightly correlated with ERBB2 copy number values obtained by conventional FISH (rs = 0.940 and rs = 0.894, P < 0.001). Using ASCO/CAP guideline-conform thresholds for categorization of breast cancers as HER2-negative, equivocal or positive, nearly perfect concordance was observed for HER2 classification by FISH and MIP (93% concordant classifications, κ = 0.87). Substantial concordance was observed for FISH and NGS/NAC (83% concordant classifications, κ = 0.62). In conclusion, MIP facilitates precise ERBB2 copy number detection and should be considered as an ancillary method for clinical HER2 testing.
Collapse
Affiliation(s)
| | | | - Mieke Raap
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Peter Braubach
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Lars Schmidt
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Hans H Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Doris Steinemann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| |
Collapse
|
37
|
Raap M, Gronewold M, Christgen H, Glage S, Bentires-Alj M, Koren S, Derksen PW, Boelens M, Jonkers J, Lehmann U, Feuerhake F, Kuehnle E, Gluz O, Kates R, Nitz U, Harbeck N, Kreipe HH, Christgen M. Lobular carcinoma in situ and invasive lobular breast cancer are characterized by enhanced expression of transcription factor AP-2β. J Transl Med 2018; 98:117-129. [PMID: 29035379 DOI: 10.1038/labinvest.2017.106] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/14/2017] [Indexed: 12/26/2022] Open
Abstract
Transcription factor AP-2β (TFAP2B) regulates embryonic organ development and is overexpressed in alveolar rhabdomyosarcoma, a rare childhood malignancy. Gene expression profiling has implicated AP-2β in breast cancer (BC). This study characterizes AP-2β expression in the mammary gland and in BC. AP-2β protein expression was assessed in the normal mammary gland epithelium, in various reactive, metaplastic and pre-invasive neoplastic lesions and in two clinical BC cohorts comprising >2000 patients. BCs from various genetically engineered mouse (GEM) models were also evaluated. Human BC cell lines served as functional models to study siRNA-mediated inhibition of AP-2β. The normal mammary gland epithelium showed scattered AP-2β-positive cells in the luminal cell layer. Various reactive and pre-invasive neoplastic lesions, including apocrine metaplasia, usual ductal hyperplasia and lobular carcinoma in situ (LCIS) showed enhanced AP-2β expression. Cases of ductal carcinoma in situ (DCIS) were more often AP-2β-negative (P<0.001). In invasive BC cohorts, AP-2β-positivity was associated with the lobular BC subtype (P<0.001), loss of E-cadherin (P<0.001), a positive estrogen receptor (ER) status (P<0.001), low Ki67 (P<0.001), low/intermediate Oncotype DX recurrence scores (P<0.001), and prolonged event-free survival (P=0.003). BCs from GEM models were all AP-2β-negative. In human BC cell lines, AP-2β expression was independent from ER-signaling. SiRNA-mediated inhibition of AP-2β diminished proliferation of lobular BC cell lines in vitro. In summary, AP-2β is a new mammary epithelial differentiation marker. Its expression is preferentially retained and enhanced in LCIS and invasive lobular BC and has prognostic implications. Our findings indicate that AP-2β controls tumor cell proliferation in this slow-growing BC subtype.
Collapse
Affiliation(s)
- Mieke Raap
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Malte Gronewold
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Silke Glage
- Institute of Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Mohammad Bentires-Alj
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Shany Koren
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Patrick W Derksen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam Boelens
- Division of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jos Jonkers
- Division of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Elna Kuehnle
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Breast Center Niederrhein, Evangelic Bethesda Hospital, Moenchengladbach, Germany
| | - Ronald Kates
- West German Study Group, Moenchengladbach, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Breast Center Niederrhein, Evangelic Bethesda Hospital, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Breast Center, Department of Obstetrics and Gynecology, University of Munich, Munich, Germany
| | - Hans H Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | |
Collapse
|
38
|
Temam S, Spicer J, Farzaneh F, Soria JC, Oppenheim D, McGurk M, Hollebecque A, Sarini J, Hussain K, Soehrman Brossard S, Manenti L, Evers S, Delmar P, Di Scala L, Mancao C, Feuerhake F, Andries L, Ott MG, Passioukov A, Delord JP. An exploratory, open-label, randomized, multicenter study to investigate the pharmacodynamics of a glycoengineered antibody (imgatuzumab) and cetuximab in patients with operable head and neck squamous cell carcinoma. Ann Oncol 2017; 28:2827-2835. [PMID: 28950289 PMCID: PMC5834084 DOI: 10.1093/annonc/mdx489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In addition to inhibiting epidermal growth factor receptor (EGFR) signaling, anti-EGFR antibodies of the IgG1 'subtype' can induce a complementary therapeutic effect through the induction of antibody-dependent cell-mediated cytotoxicity (ADCC). Glycoengineering of therapeutic antibodies increases the affinity for the Fc-gamma receptor, thereby enhancing ADCC. PATIENTS AND METHODS We investigated the changes in immune effector cells and EGFR pathway biomarkers in 44 patients with operable, advanced stage head and neck squamous cell carcinoma treated with two preoperative doses of either glycoengineered imgatuzumab (GA201; 700 or 1400 mg) or cetuximab (standard dosing) in a neoadjuvant setting with paired pre- and post-treatment tumor biopsies. RESULTS Significant antitumor activity was observed with both antibodies after just two infusions. Metabolic responses were seen in 23 (59.0%) patients overall. One imgatuzumab-treated patient (700 mg) achieved a 'pathological' complete response. An immediate and sustained decrease in peripheral natural killer cells was consistently observed with the first imgatuzumab infusion but not with cetuximab. The functionality of the remaining peripheral natural killer cells was maintained. Similarly, a pronounced increase in circulating cytokines was seen following the first infusion of imgatuzumab but not cetuximab. Overall, tumor-infiltrating CD3+ cell counts increased following treatment with both antibodies. A significant increase from baseline in CD3+/perforin+ cytotoxic T cells occurred only in the 700-mg imgatuzumab group (median 95% increase, P < 0.05). The most prominent decrease of EGFR-expressing cells was recorded after treatment with imgatuzumab (700 mg, -34.6%; 1400 mg, -41.8%). The post-treatment inflammatory tumor microenvironment was strongly related to baseline tumor-infiltrating immune cell density, and baseline levels of EGFR and pERK in tumor cells most strongly predicted therapeutic response. CONCLUSIONS These pharmacodynamic observations and relationship with efficacy are consistent with the proposed mode of action of imgatuzumab combining efficient EGFR pathway inhibition with ADCC-related immune antitumor effects. CLINICAL TRIAL REGISTRATION NUMBER NCT01046266 (ClinicalTrials.gov).
Collapse
Affiliation(s)
- S Temam
- Department of Head and Neck Surgical Oncology, Institut Gustave Roussy, Villejuif, France.
| | | | - F Farzaneh
- Department of Haematological Medicine, King's College London, London, UK
| | - J C Soria
- DITEP (Drug Development Department), Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - D Oppenheim
- Department of Haematological Medicine, King's College London, London, UK
| | - M McGurk
- Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - A Hollebecque
- DITEP (Drug Development Department), Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - J Sarini
- Department of Surgery, Institut Claudius Regaud, Toulouse, France
| | - K Hussain
- Head and Neck Surgery, King's College London, Guy's Hospital Campus, London, UK
| | | | - L Manenti
- Roche Innovation Center Zurich, Schlieren, Switzerland
| | - S Evers
- Roche Innovation Center Zurich, Schlieren, Switzerland
| | - P Delmar
- Roche Innovation Center Basel, Basel
| | | | - C Mancao
- Roche Innovation Center Basel, Basel
| | - F Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover; Institute for Neuropathology, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | | | - M G Ott
- Roche Innovation Center Basel, Basel
| | - A Passioukov
- Roche Innovation Center Zurich, Schlieren, Switzerland
| | - J P Delord
- Clinical Research Unit, Institut Claudius Regaud, Toulouse, France
| |
Collapse
|
39
|
Bug D, Oswald E, Grote A, Peille AL, Niedermann G, Merhof D, Feuerhake F, Schüler JB. Abstract 4815: Humanized single mouse trial: A preclinical platform feasible for immune-oncology drug screening and translational biomarker development. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4815] [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
The field of cancer immunology is rapidly moving towards innovative therapeutic strategies. As a consequence the need for robust and predictive preclinical platforms arises just as well. The current project aims to establish a drug screening workflow bridging between innovative mouse models and clinical biomarker development. A total of 69 NOG (NOD/Shi-scid/IL-2Rγnull) mice were engrafted with CD34+ hematopoietic stem cells. Thereafter, tumor material from 11 different lung cancer patient derived xenograft models (NSCLC PDX) was implanted subcutaneously. Individual mice were treated with α-CTLA-4, α-PD-1 or the combination thereof. With n=1 per treatment arm and model the study design followed the screening approach of the single mouse trial (SMT). Infiltration of human immune cells was detected by flow cytometry (FC) and immunohistochemistry (IHC) in hematopoietic organs and tumor tissue. A computerized analysis for digitized whole-slide images of the samples was used to quantify the lymphocyte infiltration using color classification and morphological image processing techniques. All 3 treatment arms displayed a discrete activity pattern throughout the PDX panel. Tumor models with high tumor infiltrating lymphocyte (TIL) rates in the donor patient material tended to be more sensitive towards checkpoint inhibitor treatment as models with low rates. Numbers of TILs in the PDX detected by FC and IHC were significantly increased in the treatment groups as compared to control vehicle. In parallel, hematopoietic organs showed high (>25%) amounts of huCD45 cells in all groups and models. PDX models being sensitive towards checkpoint inhibitor treatment (responders) displayed a higher percentage of DAB+ nuclei in huCD45 IHC stains than non-responder models as determined by image analysis. Irrespective thereof, in responders as well as non-responders the treatment with checkpoint inhibitors enhanced the percentage of DAB+ nuclei. Whole-slide image analysis of the H&E stains revealed an increase of the stromal compartment proportion in the tumor tissue under treatment with checkpoint inhibitors in responder models. In non-responder models the ratio between tumor and stroma was not influenced by drug treatment. The use of PDX based humanized mouse models in a SMT format allows screening approaches in complex mouse models. The combination with a comprehensive image analysis tool enables additional read-outs to quantify antitumoral activity of immune modulatory compounds. The latter can be used to identify possible biomarkers in the preclinical setting. Moreover, the translation and validation of these biomarker candidates in a clinical setting is self-evident as primary material needed for these types of analyses is easily accessible.
Citation Format: Daniel Bug, Eva Oswald, Anne Grote, Anne-Lise Peille, Gabriele Niedermann, Dorit Merhof, Friedrich Feuerhake, Julia B. Schüler. Humanized single mouse trial: A preclinical platform feasible for immune-oncology drug screening and translational biomarker development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4815. doi:10.1158/1538-7445.AM2017-4815
Collapse
Affiliation(s)
- Daniel Bug
- 1RWTH Aachen University, Aachen, Germany
| | | | - Anne Grote
- 3Hannover Medical School, Hannover, Germany
| | | | | | | | | | | |
Collapse
|
40
|
Yang M, Pan Z, Huang K, Büsche G, Feuerhake F, Chaturvedi A, Nie D, Heuser M, Thol F, von Neuhoff N, Ganser A, Li Z. Activation of TRKA receptor elicits mastocytosis in mice and is involved in the development of resistance to KIT-targeted therapy. Oncotarget 2017; 8:73871-73883. [PMID: 29088753 PMCID: PMC5650308 DOI: 10.18632/oncotarget.18027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 02/23/2017] [Accepted: 05/08/2017] [Indexed: 12/03/2022] Open
Abstract
The neurotrophins (NTs) play a key role in neuronal survival and maintenance. The TRK (tropomyosin-related kinase) tyrosine kinase receptors (TRKA, TRKB, TRKC) are high affinity receptors for NTs. There is increasing data demonstrating an important role of the TRK family in cancer initiation and progression. NTs have been known for many years to promote chemotaxis, maturation, and survival of mast cells. However, the role of NT signaling in the pathogenesis of mastocytosis is not well understood. In this study, we demonstrate that activation of TRKA by its ligand nerve growth factor (NGF) is potent to trigger a disease in mice with striking similarities to human systemic mastocytosis (SM). Moreover, activation of TRKA by NGF strongly rescues KIT inhibition-induced cell death of mast cell lines and primary mast cells from patients with SM, and this rescue effect can be efficiently blocked by entrectinib (a new pan TRK specific inhibitor). HMC-1 mast cell leukemia cells that are resistant to KIT inhibition induced by TRKA activation show reactivation of MAPK/ERK (extracellular signal-regulated kinase) and strong upregulation of early growth response 3 (EGR3), suggesting an important role of MAPK-EGR3 axis in the development of resistance to KIT inhibition. Targeting both TRK and KIT significantly prolongs survival of mice xenotransplanted with HMC-1 cells compared with targeting KIT alone. Thus, these data strongly suggest that TRKA signaling can improve neoplastic mast cell fitness. This might explain at least in part why treatment with KIT inhibitors alone so far has been disappointing in most published clinical trials for mastocytosis. Our data suggest that targeting both KIT and TRKs might improve efficacy of molecular therapy in SM with KIT mutations.
Collapse
Affiliation(s)
- Min Yang
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Zengkai Pan
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Kezhi Huang
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Guntram Büsche
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Anuhar Chaturvedi
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Danian Nie
- Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Felicitas Thol
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Nils von Neuhoff
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Zhixiong Li
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| |
Collapse
|
41
|
Schaadt NS, Alfonso JCL, Schönmeyer R, Grote A, Forestier G, Wemmert C, Krönke N, Stoeckelhuber M, Kreipe HH, Hatzikirou H, Feuerhake F. Image analysis of immune cell patterns in the human mammary gland during the menstrual cycle refines lymphocytic lobulitis. Breast Cancer Res Treat 2017; 164:305-315. [PMID: 28444535 DOI: 10.1007/s10549-017-4239-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/07/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE To improve microscopic evaluation of immune cells relevant in breast cancer oncoimmunology, we aim at distinguishing normal infiltration patterns from lymphocytic lobulitis by advanced image analysis. We consider potential immune cell variations due to the menstrual cycle and oral contraceptives in non-neoplastic mammary gland tissue. METHODS Lymphocyte and macrophage distributions were analyzed in the anatomical context of the resting mammary gland in immunohistochemically stained digital whole slide images obtained from 53 reduction mammoplasty specimens. Our image analysis workflow included automated regions of interest detection, immune cell recognition, and co-registration of regions of interest. RESULTS In normal lobular epithelium, seven CD8[Formula: see text] lymphocytes per 100 epithelial cells were present on average and about 70% of this T-lymphocyte population was lined up along the basal cell layer in close proximity to the epithelium. The density of CD8[Formula: see text] T-cell was 1.6 fold higher in the luteal than in the follicular phase in spontaneous menstrual cycles and 1.4 fold increased under the influence of oral contraceptives, and not co-localized with epithelial proliferation. CD4[Formula: see text] T-cells were infrequent. Abundant CD163[Formula: see text] macrophages were widely spread, including the interstitial compartment, with minor variation during the menstrual cycle. CONCLUSIONS Spatial patterns of different immune cell subtypes determine the range of normal, as opposed to inflammatory conditions of the breast tissue microenvironment. Advanced image analysis enables quantification of hormonal effects, refines lymphocytic lobulitis, and shows potential for comprehensive biopsy evaluation in oncoimmunology.
Collapse
Affiliation(s)
- Nadine S Schaadt
- Institute of Pathology, Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Juan Carlos López Alfonso
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany
| | - Ralf Schönmeyer
- Definiens AG, Bernhard-Wicki-Straße 5, 80636, Munich, Germany
| | - Anne Grote
- Institute of Pathology, Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Germain Forestier
- MIPS, University of Haute Alsace, 12 rue des Freres Lumiere, 68093, Mulhouse, France
| | - Cédric Wemmert
- ICube, University of Strasbourg, 300 bvd Sebastien Brant, 67412, Illkirch, France
| | - Nicole Krönke
- Institute of Pathology, Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Mechthild Stoeckelhuber
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaningerstraße 22, 81675, Munich, Germany
| | - Hans H Kreipe
- Institute of Pathology, Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Haralampos Hatzikirou
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany
| | - Friedrich Feuerhake
- Institute of Pathology, Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
- University Clinic of Freiburg, Institute for Neuropathology, Breisacher Str. 64, 76106, Freiburg, Germany.
| |
Collapse
|
42
|
Bug D, Schneider S, Grote A, Oswald E, Feuerhake F, Schüler J, Merhof D. Context-Based Normalization of Histological Stains Using Deep Convolutional Features. Deep Learning in Medical Image Analysis and Multimodal Learning for Clinical Decision Support 2017. [DOI: 10.1007/978-3-319-67558-9_16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
43
|
Oswald E, Grote A, Bug D, Löhr A, Lenhardt D, Niedermann G, Merhof D, Feuerhake F, Schüler J. Development and validation of a patient derived xenograft based preclinical platform for immuno-oncology drug development. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32920-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
44
|
Alfonso JCL, Köhn-Luque A, Stylianopoulos T, Feuerhake F, Deutsch A, Hatzikirou H. Why one-size-fits-all vaso-modulatory interventions fail to control glioma invasion: in silico insights. Sci Rep 2016; 6:37283. [PMID: 27876890 PMCID: PMC5120360 DOI: 10.1038/srep37283] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 07/27/2016] [Accepted: 10/26/2016] [Indexed: 12/18/2022] Open
Abstract
Gliomas are highly invasive brain tumours characterised by poor prognosis and limited response to therapy. There is an ongoing debate on the therapeutic potential of vaso-modulatory interventions against glioma invasion. Prominent vasculature-targeting therapies involve tumour blood vessel deterioration and normalisation. The former aims at tumour infarction and nutrient deprivation induced by blood vessel occlusion/collapse. In contrast, the therapeutic intention of normalising the abnormal tumour vasculature is to improve the efficacy of conventional treatment modalities. Although these strategies have shown therapeutic potential, it remains unclear why they both often fail to control glioma growth. To shed some light on this issue, we propose a mathematical model based on the migration/proliferation dichotomy of glioma cells in order to investigate why vaso-modulatory interventions have shown limited success in terms of tumour clearance. We found the existence of a critical cell proliferation/diffusion ratio that separates glioma responses to vaso-modulatory interventions into two distinct regimes. While for tumours, belonging to one regime, vascular modulations reduce the front speed and increase the infiltration width, for those in the other regime, the invasion speed increases and infiltration width decreases. We discuss how these in silico findings can be used to guide individualised vaso-modulatory approaches to improve treatment success rates.
Collapse
Affiliation(s)
- J C L Alfonso
- Braunschweig Integrated Centre of Systems Biology and Helmholtz Center for Infectious Research, Braunschweig, Germany.,Center for Information Services and High Performance Computing, Technische Universität Dresden, Germany
| | - A Köhn-Luque
- Department of Biostatistics, Faculty of Medicine, University of Oslo, Norway.,BigInsight, Centre for Research-based Innovation (SFI), Oslo, Norway
| | - T Stylianopoulos
- Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - F Feuerhake
- Institute of Pathology, Medical School of Hannover, Germany.,Institute of Neuropathology, University Clinic Freiburg, Germany
| | - A Deutsch
- Center for Information Services and High Performance Computing, Technische Universität Dresden, Germany
| | - H Hatzikirou
- Braunschweig Integrated Centre of Systems Biology and Helmholtz Center for Infectious Research, Braunschweig, Germany
| |
Collapse
|
45
|
Otte A, Yang Y, von der Ohe J, Melzer C, Hillemanns P, Feuerhake F, Hass R. SCCOHT tumors acquire chemoresistance and protection by interacting mesenchymal stroma/stem cells within the tumor microenvironment. Int J Oncol 2016; 49:2453-2463. [PMID: 27748897 DOI: 10.3892/ijo.2016.3735] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 09/19/2016] [Indexed: 11/05/2022] Open
Abstract
Chemotherapeutic drug testing of SCCOHT-1 and BIN-67 tumor cells revealed synergistic growth-inhibition of >95% in vitro with a combination of foretinib and FK228. Application of this drug combination in vivo in NODscid mice-induced SCCOHT-1GFP tumors was associated with ~6-fold reduction in tumor mass within 10 days, whereby synergistic effects of the two compounds remained undetectable compared to previous results with foretinib treatment alone. Histopathologic evaluation revealed a reduced vascularization and a lower amount of proliferating cells in the treated tumors. Surprisingly, a simultaneous significant accumulation of extracellular matrix structures with positive elastin-van Gieson staining was observed following foretinib/FK228 exposure. Expression analysis of treated animal tumors exhibited various changes including increased mouse transcript levels of elastin, laminin, and fibronectin. In parallel, markers for mesenchymal stroma/stem cells (MSC) including CD73 and CD90 were detectable in all mouse tumors suggesting a possible involvement of these cells in extracellular matrix restructure. Indeed, incubation of MSC with FK228 or foretinib/FK228 demonstrated morphologic alterations and enhanced expression of laminin and fibronectin. Moreover, a co-culture of MSC with lentiviral-labeled SCCOHT-1GFP cells contributed to protection of the tumor cells against FK228-mediated cytotoxicity. Furthermore, explant cultures of SCCOHT-1GFP-induced tumors acquired an increased resistance to FK228 and a combination of foretinib/FK228 in contrast to foretinib alone. Together, these data suggested that FK228-mediated extracellular matrix protein expression by MSC contributes to increased protection and enhanced resistance of SCCOHT tumors which could represent a more general mechanism of MSC during drug-induced alterations of a tumor microenvironment.
Collapse
Affiliation(s)
- Anna Otte
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| | - Yuanyuan Yang
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| | - Juliane von der Ohe
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| | - Catharina Melzer
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| | - Peter Hillemanns
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| | | | - Ralf Hass
- Biochemistry and Tumor Biology Lab, Department of Obstetrics and Gynecology, Hannover Medical School, D-30625 Hannover, Germany
| |
Collapse
|
46
|
Otte A, Rauprich F, von der Ohe J, Yang Y, Kommoss F, Feuerhake F, Hillemanns P, Hass R. c-Met inhibitors attenuate tumor growth of small cell hypercalcemic ovarian carcinoma (SCCOHT) populations. Oncotarget 2016; 6:31640-58. [PMID: 26436697 PMCID: PMC4741630 DOI: 10.18632/oncotarget.5151] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 02/16/2015] [Accepted: 09/18/2015] [Indexed: 01/01/2023] Open
Abstract
A cellular model (SCCOHT-1) of the aggressive small cell hypercalcemic ovarian carcinoma demonstrated constitutive chemokine and growth factor production including HGF. A simultaneous presence of c-Met in 41% SCCOHT-1 cells suggested an autocrine growth mechanism. Expression of c-Met was also observed at low levels in the corresponding BIN-67 cell line (6.5%) and at high levels in ovarian adenocarcinoma cells (NIH:OVCAR-3 (84.4%) and SK-OV-3 (99.3%)). Immunohistochemistry of c-Met expression in SCCOHT tumors revealed a heterogeneous distribution between undetectable levels and 80%. Further characterization of SCCOHT-1 and BIN-67 cells by cell surface markers including CD90 and EpCAM demonstrated similar patterns with differences to the ovarian adenocarcinoma cells. HGF stimulation of SCCOHT-1 cells was associated with c-Met phosphorylation at Tyr1349 and downstream Thr202/Tyr204 phosphorylation of p44/42 MAP kinase. This HGF-induced signaling cascade was abolished by the c-Met inhibitor foretinib. Cell cycle analysis after foretinib treatment demonstrated enhanced G2 accumulation and increasing apoptosis within 72 h. Moreover, the IC50 of foretinib revealed 12.4 nM in SCCOHT-1 cells compared to 411 nM and 481 nM in NIH:OVCAR-3 and SK-OV-3 cells, respectively, suggesting potential therapeutic effects. Indeed, SCCOHT-1 and BIN-67 tumor xenografts in NODscid mice exhibited an approximately 10-fold and 5-fold reduced tumor size following systemic application of foretinib, respectively. Furthermore, foretinib-treated tumors revealed a significantly reduced vascularization and little if any c-Met-mediated signal transduction. Similar findings of reduced proliferative capacity and declined tumor size were observed after siRNA-mediated c-Met knock-down in SCCOHT-1 cells demonstrating that in vivo inhibition of these pathways contributed to an attenuation of SCCOHT tumor growth.
Collapse
Affiliation(s)
- Anna Otte
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Finn Rauprich
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Juliane von der Ohe
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Yuanyuan Yang
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Friedrich Kommoss
- Synlab MVZ Pathologie Mannheim GmbH, Referral Center for Gynecopathology, Mannheim, Germany
| | | | - Peter Hillemanns
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Ralf Hass
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
47
|
Liedtke C, Gluz O, Heinisch F, Feuerhake F, Kreipe HH, Clemens M, Nuding B, Kraemer S, Reimer T, Svedman C, Shak S, Nitz U, Kates RE, Harbeck N, Christgen M. Abstract P2-07-01: Association of TILs with clinical parameters, recurrence score, and prognosis in patients with early HER2-negative breast cancer (BC) – A translational analysis of the prospective WSG planB trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-07-01] [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:
Tumor-infiltrating lymphocytes (TILs) have been associated with prognosis and with chemotherapy response among patients with BC, particularly in presence of high-risk features. The WSG planB trial randomized 2448 patients with HER2- N0/1 BC for comparison of anthracycline-free (6xTC) vs. standard anthracycline-taxane chemotherapy (4xEC-4xDoc). Recurrence Score® (RS) was incorporated for risk stratification in hormone receptor positive (HR+) BC. The present analysis focuses on the correlation of TILs with clinical/pathological parameters and their prognostic impact among planB patients.
Methods:
Stromal TILs were evaluated using a pathologist and two-observer approach. Three independent observers evaluated digital sections on H&E staining as previously suggested (Salgado et al., Ann Oncol. 2014); the median of the three values (TILmed) was used for statistical analysis. Spearman correlations of TILmed with clinical/pathological parameters (including central KI67 expression, quantitative ER measurements, nodal involvement, and RS) and univariate impact on event-free survival (EFS) were analyzed.
Results:
Our analysis included 300 patients with HR- and 1124 patients with HR+ HER2- BC. Both in HR- and HR+ BC, a significant association between TILmed and (i) central grading (correlation coefficient r=0.147, p=0.012 and r=0.195, p<0.001, respectively) and (ii) central Ki67 expression (r=0.202, p=0.001 and r=0.152 and p<0.001) was observed. Among HR+ cases, a significant association between TILmed and quantitative ER measurements (r=-0.412, p=0.041) and RS (r=0.190, p<0.001) was found. Furthermore, univariate Cox analysis revealed a significant association between TILmed (coded as fractional rank) and event-free survival (EFS). The hazard ratio of 75th to 25th percentile was 1.58 (95%CI: 1.06-2.36, p=0.025). This impact was not separately significant in HR subgroups due to lack of events
Conclusion:
In this dataset, presence of stromal TILs was moderately associated with clinical features of high-risk breast cancer (including RS) and decreased EFS. TILs will be evaluated as a prognostic or predictive factor (in multivariate and subgroup analyses) when the outcome results are evaluated after prolonged follow up. Furthermore, an updated analysis including the complete planB dataset will be presented.
Citation Format: Liedtke C, Gluz O, Heinisch F, Feuerhake F, Kreipe HH, Clemens M, Nuding B, Kraemer S, Reimer T, Svedman C, Shak S, Nitz U, Kates RE, Harbeck N, Christgen M. Association of TILs with clinical parameters, recurrence score, and prognosis in patients with early HER2-negative breast cancer (BC) – A translational analysis of the prospective WSG planB trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-07-01.
Collapse
Affiliation(s)
- C Liedtke
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - O Gluz
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - F Heinisch
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - F Feuerhake
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - HH Kreipe
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - M Clemens
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - B Nuding
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - S Kraemer
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - T Reimer
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - C Svedman
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - S Shak
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - U Nitz
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - RE Kates
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - N Harbeck
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| | - M Christgen
- Westdeutsche Studiengruppe GmbH, Moenchengladbach, Germany; University Clinics Schleswig-Holstein/Campus Luebeck, Women's Clinic; Ev. Hospital Bethesda, Breast Center Niederrhein; Medical School Hannover, Institute of Pathology; Mutterhaus der Borromäerinnen Trier; Ev. Hospital Bergisch Gladbach; University Clinics Cologne, Breast Center; Clinics Suedstadt Rostock; Genomic Health, Inc.; Palleos Healthcare Services, Statistics; Breast Center, University of Munich and CCCLMU
| |
Collapse
|
48
|
Cannarile M, Hoves S, Broeske AM, Benz J, Wartha K, Runza V, Rey-Giraud F, Pradel LP, Feuerhake F, Klaman I, Jones T, Jucknischke U, Scheiblich S, Gorr IH, Walz A, Abiraj K, Cassier P, Sica A, Gomez-Roca C, Tourneau CL, Delord JP, Italiano A, Levitsky H, Blay JY, Ruettinger D, Ries CH. Abstract PR04: Targeting tumor-asoociated macrophages with a novel anti-CSF1R antibody in cancer patients. Cancer Res 2015. [DOI: 10.1158/1538-7445.chtme14-pr04] [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
Myeloid cells represent the most abundant immune cell type within the tumor microenvironment of certain tumor entities, including tumor associated macrophages (TAMs). Macrophage infiltration has been identified as an independent poor prognostic factor in several cancer types. The major survival factor for TAMs is macrophage colony stimulating factor 1 (CSF1). We generated a monoclonal antibody (RG7155) that binds to the secondary dimerization interface of CSF1 receptor (CSF1R) as a specific and potent allosteric inhibitor. In vitro, RG7155 treatment results in cell death of CSF1-differentiated macrophages. In animal models, CSF1R inhibition reduced the F4/80+ TAMs infiltrate by 90% and was accompanied by an increase of the CD8+/CD4+ T cell ratio. The ability of RG7155 to reduce TAMs is currently evaluated in a first-in-man phase I clinical study in patients suffering either from pigmented villonodular synovitis (PVNS), a neoplastic disorder characterized by CSF1 overexpression, or other tumor entities. The associated biomarker program involves mandatory paired pre- and on-treatment biopsies of tumor and surrogate skin tissue as well as pharmacodynamic marker assessment in circulating blood. In patients treated with RG7155 an increase of CSF1 associated with a sustained decrease of CD14+CD16+ alternatively activated monocytes in peripheral blood was detected. In PVNS patients administration of RG7155 led to striking reductions of CSF1R+ and CD163+ macrophages in tumor tissue resulting in objective clinical responses according to RECIST (Response Evaluation Criteria in Solid Tumors) in 5 out of 6 patients. All six evaluable PVNS patients showed partial metabolic response in FDG-PET imaging and significant symptomatic improvement as early as 4 weeks after treatment initiation. Furthermore, TAM reduction was also observed in paired tumor samples of patients with various advanced solid malignancies, suggesting broad applicability of this therapeutic approach.
This abstract is also presented as Poster A50.
Citation Format: Michael Cannarile, Sabine Hoves, Ann-Marie Broeske, Joerg Benz, Katharina Wartha, Valeria Runza, Flora Rey-Giraud, Leon P. Pradel, Friedrich Feuerhake, Irina Klaman, Tobin Jones, Ute Jucknischke, Stefan Scheiblich, Ingo H. Gorr, Antje Walz, Keelara Abiraj, Philippe Cassier, Antonio Sica, Carlos Gomez-Roca, Christophe Le Tourneau, Jean-Pierre Delord, Antoine Italiano, Hyam Levitsky, Jean-Yves Blay, Dominik Ruettinger, Carola H. Ries. Targeting tumor-asoociated macrophages with a novel anti-CSF1R antibody in cancer patients. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr PR04. doi:10.1158/1538-7445.CHTME14-PR04
Collapse
Affiliation(s)
- Michael Cannarile
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Sabine Hoves
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Ann-Marie Broeske
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Joerg Benz
- 2Pharma Research&Early Development F.Hoffmann-La Roche, Basel, Switzerland,
| | - Katharina Wartha
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Valeria Runza
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Flora Rey-Giraud
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Leon P. Pradel
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | | | - Irina Klaman
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Tobin Jones
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Ute Jucknischke
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Stefan Scheiblich
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Ingo H. Gorr
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Antje Walz
- 2Pharma Research&Early Development F.Hoffmann-La Roche, Basel, Switzerland,
| | - Keelara Abiraj
- 2Pharma Research&Early Development F.Hoffmann-La Roche, Basel, Switzerland,
| | | | | | | | | | | | | | - Hyam Levitsky
- 9Roche Pharma Research and Early Development Oncology, Roche Glycart, Schlieren, Switzerland
| | | | - Dominik Ruettinger
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| | - Carola H. Ries
- 1Roche Pharma Research and Early Development Oncology, Penzberg, Germany,
| |
Collapse
|
49
|
Grote A, Abbas M, Linder N, Kreipe HH, Lundin J, Feuerhake F. Exploring the spatial dimension of estrogen and progesterone signaling: detection of nuclear labeling in lobular epithelial cells in normal mammary glands adjacent to breast cancer. Diagn Pathol 2014; 9 Suppl 1:S11. [PMID: 25565114 PMCID: PMC4305969 DOI: 10.1186/1746-1596-9-s1-s11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Comprehensive spatial assessment of hormone receptor immunohistochemistry staining in digital whole slide images of breast cancer requires accurate detection of positive nuclei within biologically relevant regions of interest. Herein, we propose a combination of automated region labeling at low resolution and subsequent detailed tissue evaluation of subcellular structures in lobular structures adjacent to breast cancer, as a proof of concept for the approach to analyze estrogen and progesterone receptor expression in the spatial context of surrounding tissue. METHODS Routinely processed paraffin sections of hormone receptor-negative ductal invasive breast cancer were stained for estrogen and progesterone receptor by immunohistochemistry. Digital whole slides were analyzed using commercially available image analysis software for advanced object-based analysis, applying textural, relational, and geometrical features. Mammary gland lobules were targeted as regions of interest for analysis at subcellular level in relation to their distance from coherent tumor as neighboring relevant tissue compartment. Lobule detection quality was evaluated visually by a pathologist. RESULTS After rule set optimization in an estrogen receptor-stained training set, independent test sets (progesterone and estrogen receptor) showed acceptable detection quality in 33% of cases. Presence of disrupted lobular structures, either by brisk inflammatory infiltrate, or diffuse tumor infiltration, was common in cases with lower detection accuracy. Hormone receptor detection tended towards higher percentage of positively stained nuclei in lobules distant from the tumor border as compared to areas adjacent to the tumor. After adaptations of image analysis, corresponding evaluations were also feasible in hormone receptor positive breast cancer, with some limitations of automated separation of mammary epithelial cells from hormone receptor-positive tumor cells. CONCLUSIONS As a proof of concept for object-oriented detection of steroid hormone receptors in their spatial context, we show that lobular structures can be classified based on texture-based image features, unless brisk inflammatory infiltration disrupts the normal morphological structure of the tubular gland epithelium. We consider this approach as prototypic for detection and spatial analysis of nuclear markers in defined regions of interest. We conclude that advanced image analysis at this level of complexity requires adaptation to the individual tumor phenotypes and morphological characteristics of the tumor environment.
Collapse
|
50
|
Ries CH, Cannarile MA, Hoves S, Benz J, Wartha K, Runza V, Rey-Giraud F, Pradel LP, Feuerhake F, Klaman I, Jones T, Jucknischke U, Scheiblich S, Kaluza K, Gorr IH, Walz A, Abiraj K, Cassier PA, Sica A, Gomez-Roca C, de Visser KE, Italiano A, Le Tourneau C, Delord JP, Levitsky H, Blay JY, Rüttinger D. Targeting tumor-associated macrophages with anti-CSF-1R antibody reveals a strategy for cancer therapy. Cancer Cell 2014; 25:846-59. [PMID: 24898549 DOI: 10.1016/j.ccr.2014.05.016] [Citation(s) in RCA: 927] [Impact Index Per Article: 92.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 02/05/2014] [Accepted: 05/21/2014] [Indexed: 11/21/2022]
Abstract
Macrophage infiltration has been identified as an independent poor prognostic factor in several cancer types. The major survival factor for these macrophages is macrophage colony-stimulating factor 1 (CSF-1). We generated a monoclonal antibody (RG7155) that inhibits CSF-1 receptor (CSF-1R) activation. In vitro RG7155 treatment results in cell death of CSF-1-differentiated macrophages. In animal models, CSF-1R inhibition strongly reduces F4/80(+) tumor-associated macrophages accompanied by an increase of the CD8(+)/CD4(+) T cell ratio. Administration of RG7155 to patients led to striking reductions of CSF-1R(+)CD163(+) macrophages in tumor tissues, which translated into clinical objective responses in diffuse-type giant cell tumor (Dt-GCT) patients.
Collapse
MESH Headings
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized
- Cell Differentiation/physiology
- Cell Line, Tumor
- Clinical Trials, Phase I as Topic
- Cohort Studies
- Colonic Neoplasms/immunology
- Colonic Neoplasms/metabolism
- Colonic Neoplasms/therapy
- Female
- Humans
- Macaca fascicularis
- Macrophages/cytology
- Macrophages/drug effects
- Macrophages/immunology
- Macrophages/metabolism
- Male
- Mice, Inbred C57BL
- Models, Molecular
- Receptor, Macrophage Colony-Stimulating Factor/antagonists & inhibitors
- Receptor, Macrophage Colony-Stimulating Factor/immunology
- Receptor, Macrophage Colony-Stimulating Factor/metabolism
Collapse
Affiliation(s)
- Carola H Ries
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany.
| | - Michael A Cannarile
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Sabine Hoves
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Jörg Benz
- Roche Innovation Center Basel, Small Molecule Research, Roche Pharmaceutical Research and Early Development, 4070 Basel, Switzerland
| | - Katharina Wartha
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Valeria Runza
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Flora Rey-Giraud
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Leon P Pradel
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | | | - Irina Klaman
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Tobin Jones
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Ute Jucknischke
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Stefan Scheiblich
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Klaus Kaluza
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Ingo H Gorr
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| | - Antje Walz
- Roche Innovation Center Basel, Pharmaceutical Sciences and Oncology Division, Roche Pharmaceutical Research and Early Development, 4070 Basel, Switzerland
| | - Keelara Abiraj
- Roche Innovation Center Basel, Pharmaceutical Sciences and Oncology Division, Roche Pharmaceutical Research and Early Development, 4070 Basel, Switzerland
| | | | - Antonio Sica
- Humanitas Clinical and Research Center, 20089 Milan, Italy; Department of Pharmaceutical Sciences, University of Piemonte, 28100 Novara, Italy
| | - Carlos Gomez-Roca
- Department of Medicine, Institut Claudius Regaud, 31000 Toulouse, France
| | - Karin E de Visser
- Division of Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, 33076 Bordeaux, France
| | | | - Jean-Pierre Delord
- Department of Medicine, Institut Claudius Regaud, 31000 Toulouse, France
| | - Hyam Levitsky
- Roche Innovation Center Zurich, Oncology Division, Roche Pharmaceutical Research and Early Development, 8952 Zurich, Switzerland
| | - Jean-Yves Blay
- Department of Medicine, Centre Léon Bérard, 69008 Lyon, France
| | - Dominik Rüttinger
- Roche Innovation Center Penzberg, Oncology Division, Roche Pharmaceutical Research and Early Development, 82377 Penzberg, Germany
| |
Collapse
|