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Longo L, Cruz K, Cadot N, Sarrouy E, Ricciardi G, Eloy C. Drag coefficient estimation in FSI for PWR fuel assembly bowing. Nuclear Engineering and Design 2022. [DOI: 10.1016/j.nucengdes.2022.111995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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HOGSTROM JENNY, Cruz K, Patel J, Mehta T, Warren A, Muranen T. Abstract 3462: Modeling drug resistance in hormone receptor positive breast cancer using patient derived organoid cultures and cancer associated fibroblasts. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3462] [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
Breast cancer is the most prevalent cancer among women worldwide. Estrogen receptor-positive (ER+) breast cancer constitutes roughly 70% of all breast cancers. Early-stage ER+ breast cancers usually respond well to ER-targeted therapies. However, only 20-40% of patients with advanced ER+ breast cancer respond to ER-targeted therapy. Recently, three inhibitors for the cyclin-dependent kinase 4/6 (CDK4/6) were approved as first-line and/or second-line treatment in combination with ER-targeted therapies. Unfortunately, despite initial response to the combination treatment, patients acquire resistance to both ER-targeted therapies and CDK4/6 inhibitors over time. As a result of this, the 5-year survival of women with metastatic breast cancer is 28%. A large contribution to this poor survival rate is the desmoplastic nature of the tumor microenvironment. Desmoplasia is characterized by the abnormal growth of fibroblasts and a dense extracellular matrix. The role of desmoplasia in breast cancer and its contribution to promoting a pro-tumor environment by limiting nutrients and oxygen has been extensively studied. However, the role of secreted factors such as cytokines and metabolites by cancer-associated fibroblasts (CAFs) has been poorly studied in the context of targeted drug resistance and its effects on tumor behavior. Therefore, to investigate the mechanism of stroma-mediated resistance to targeted therapies, we have propagated patient-derived organoids and CAFs from treatment-naïve and treatment-resistant ER+ breast tumors. Our data shows that conditioned media from CAFs have variable ability to drive resistance to hormone therapy and CDK4/6 inhibitors. To identify secreted factors that drive resistance, we have performed cytokine arrays and untargeted metabolomics of the CAF lines that were the strongest drivers of resistance. We have identified several cytokines, such as IL-5, IL-8 and YKL40, that were secreted by all CAF lines. Furthermore, many CAF lines secreted the TCA cycle intermediates α-ketoglutarate and succinate, which have been implicated as oncometabolites in solid tumors. Our preliminary data suggests that YKL40, and succinate induce drug resistance. Together, this suggests that these factors secreted by CAFs play a role in supporting a pro-tumor environment by promoting drug resistance. Defining this mechanism of resistance to ER-targeted therapy and CDK4/6 inhibitors will elucidate potential therapeutic targets to enhance patient response to therapy.
Citation Format: JENNY HOGSTROM, Kayla Cruz, Jaymin Patel, Tejas Mehta, Angelica Warren, Taru Muranen. Modeling drug resistance in hormone receptor positive breast cancer using patient derived organoid cultures and cancer associated fibroblasts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3462.
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Affiliation(s)
| | - Kayla Cruz
- 1Beth Israel Deaconess Medical Center, Boston, MA
| | - Jaymin Patel
- 1Beth Israel Deaconess Medical Center, Boston, MA
| | - Tejas Mehta
- 1Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Taru Muranen
- 1Beth Israel Deaconess Medical Center, Boston, MA
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Dennison L, Ruggieri A, Mohan A, Leatherman J, Cruz K, Woolman S, Azad N, Lesinski GB, Jaffee EM, Yarchoan M. Context-Dependent Immunomodulatory Effects of MEK Inhibition are Enhanced with T-cell Agonist Therapy. Cancer Immunol Res 2021; 9:1187-1201. [PMID: 34389557 DOI: 10.1158/2326-6066.cir-21-0147] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
MEK inhibition (MEKi) is proposed to enhance antitumor immunity but has demonstrated mixed results as an immunomodulatory strategy in human clinical trials. MEKi exerts direct immunomodulatory effects on tumor cells and tumor-infiltrating lymphocytes, but these effects have not been independently investigated. Here we modeled tumor-specific MEKi through CRISPR/Cas-mediated genome editing of tumor cells (MEK1 KO) and pharmacologic MEKi with cobimetinib in a RAS-driven model of colorectal cancer. This approach allowed us to distinguish tumor-mediated and tumor-independent mechanisms of MEKi immunomodulation. MEK1 KO tumors demonstrated upregulation of JAK/STAT signaling; enhanced MHCI expression, CD8+ T-cell infiltration and T-cell activation; and impaired tumor growth that is immune-dependent. Pharmacologic MEKi recapitulated tumor-intrinsic effects but simultaneously impaired T-cell activation in the tumor microenvironment. We confirmed a reduction in human peripheral lymphocyte activation from a clinical trial of anti-PD-L1 (atezolizumab) with or without cobimetinib in biliary tract cancers. Impaired activation of tumor-infiltrating lymphocytes treated with pharmacologic MEKi was reversible and was rescued with the addition of a 41BB agonist. Collectively, these data underscore the ability of MEKi to induce context-dependent immunomodulatory effects and suggest that T cell-agonist therapy maximizes the beneficial effects of MEKi on the antitumor immune response.
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Affiliation(s)
| | - Amanda Ruggieri
- Hematology and Medical Oncology, Winship Cancer Institute of Emory University
| | - Aditya Mohan
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
| | | | | | - Skylar Woolman
- Biomedical Science, West Virginia School of Osteopathic Medicine
| | - Nilofer Azad
- Department of Medical Oncology, Johns Hopkins University
| | - Gregory B Lesinski
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University
| | | | - Mark Yarchoan
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
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4
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Ho WJ, Erbe R, Danilova L, Phyo Z, Bigelow E, Stein-O'Brien G, Thomas DL, Charmsaz S, Gross N, Woolman S, Cruz K, Munday RM, Zaidi N, Armstrong TD, Sztein MB, Yarchoan M, Thompson ED, Jaffee EM, Fertig EJ. Multi-omic profiling of lung and liver tumor microenvironments of metastatic pancreatic cancer reveals site-specific immune regulatory pathways. Genome Biol 2021; 22:154. [PMID: 33985562 PMCID: PMC8118107 DOI: 10.1186/s13059-021-02363-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 05/31/2020] [Accepted: 04/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The majority of pancreatic ductal adenocarcinomas (PDAC) are diagnosed at the metastatic stage, and standard therapies have limited activity with a dismal 5-year survival rate of only 8%. The liver and lung are the most common sites of PDAC metastasis, and each have been differentially associated with prognoses and responses to systemic therapies. A deeper understanding of the molecular and cellular landscape within the tumor microenvironment (TME) metastasis at these different sites is critical to informing future therapeutic strategies against metastatic PDAC. RESULTS By leveraging combined mass cytometry, immunohistochemistry, and RNA sequencing, we identify key regulatory pathways that distinguish the liver and lung TMEs in a preclinical mouse model of metastatic PDAC. We demonstrate that the lung TME generally exhibits higher levels of immune infiltration, immune activation, and pro-immune signaling pathways, whereas multiple immune-suppressive pathways are emphasized in the liver TME. We then perform further validation of these preclinical findings in paired human lung and liver metastatic samples using immunohistochemistry from PDAC rapid autopsy specimens. Finally, in silico validation with transfer learning between our mouse model and TCGA datasets further demonstrates that many of the site-associated features are detectable even in the context of different primary tumors. CONCLUSIONS Determining the distinctive immune-suppressive features in multiple liver and lung TME datasets provides further insight into the tissue specificity of molecular and cellular pathways, suggesting a potential mechanism underlying the discordant clinical responses that are often observed in metastatic diseases.
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Affiliation(s)
- Won Jin Ho
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- The Johns Hopkins Cancer Convergence Institute, Baltimore, USA
- Skip Viragh Center for Pancreatic Cancer, Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, 4M07 Bunting Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21287, USA
| | - Rossin Erbe
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, USA
| | - Ludmila Danilova
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Zaw Phyo
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Emma Bigelow
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | | | - Dwayne L Thomas
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Soren Charmsaz
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Nicole Gross
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Skylar Woolman
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Kayla Cruz
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Rebecca M Munday
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, USA
| | - Neeha Zaidi
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- Skip Viragh Center for Pancreatic Cancer, Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, 4M07 Bunting Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21287, USA
| | - Todd D Armstrong
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Marcelo B Sztein
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mark Yarchoan
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
| | - Elizabeth D Thompson
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA
- Skip Viragh Center for Pancreatic Cancer, Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, 4M07 Bunting Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21287, USA
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, USA
| | - Elizabeth M Jaffee
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA.
- The Johns Hopkins Cancer Convergence Institute, Baltimore, USA.
- Skip Viragh Center for Pancreatic Cancer, Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, 4M07 Bunting Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21287, USA.
| | - Elana J Fertig
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N Broadway Suite 1101E, Baltimore, MD, 21209, USA.
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, USA.
- Department of Applied Mathematics and Statistics, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, USA.
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Yarchoan M, Ho WJ, Mohan A, Shah Y, Vithayathil T, Leatherman J, Dennison L, Zaidi N, Ganguly S, Woolman S, Cruz K, Armstrong TD, Jaffee EM. Effects of B cell-activating factor on tumor immunity. JCI Insight 2020; 5:136417. [PMID: 32434989 DOI: 10.1172/jci.insight.136417] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/09/2020] [Indexed: 12/17/2022] Open
Abstract
Immunotherapies that modulate T cell function have been firmly established as a pillar of cancer therapy, whereas the potential for B cells in the antitumor immune response is less established. B cell-activating factor (BAFF) is a B cell-activating cytokine belonging to the TNF ligand family that has been associated with autoimmunity, but little is known about its effects on cancer immunity. We find that BAFF upregulates multiple B cell costimulatory molecules; augments IL-12a expression, consistent with Be-1 lineage commitment; and enhances B cell antigen-presentation to CD4+ Th cells in vitro. In a syngeneic mouse model of melanoma, BAFF upregulates B cell CD40 and PD-L1 expression; it also modulates T cell function through increased T cell activation and TH1 polarization, enhanced expression of the proinflammatory leukocyte trafficking chemokine CCR6, and promotion of a memory phenotype, leading to enhanced antitumor immunity. Similarly, adjuvant BAFF promotes a memory phenotype of T cells in vaccine-draining lymph nodes and augments the antitumor efficacy of whole cell vaccines. BAFF also has distinct immunoregulatory functions, promoting the expansion of CD4+Foxp3+ Tregs in the spleen and tumor microenvironment (TME). Human melanoma data from The Cancer Genome Atlas (TCGA) demonstrate that BAFF expression is positively associated with overall survival and a TH1/IFN-γ gene signature. These data support a potential role for BAFF signaling as a cancer immunotherapy.
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Engstrom TA, Pogoda K, Cruz K, Janmey PA, Schwarz JM. Compression stiffening in biological tissues: On the possibility of classic elasticity origins. Phys Rev E 2019; 99:052413. [PMID: 31212528 DOI: 10.1103/physreve.99.052413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Indexed: 11/07/2022]
Abstract
Compression stiffening, or an increase in shear modulus with increasing compressive strain, has been observed in recent rheometry experiments on brain, liver, and fat tissues. Here we extend the known types of biomaterials exhibiting this phenomenon to include agarose gel and fruit flesh. The data reveal a linear relationship between shear storage modulus and uniaxial prestress, even up to 40% strain in some cases. We focus on this less-familiar linear relationship to show that two different results from classic elasticity theory can account for the phenomenon of linear compression stiffening. One result is due to Barron and Klein, extended here to the relevant geometry and prestresses; the other is due to Birch. For incompressible materials, there are no adjustable parameters in either theory. Which one applies to a given situation is a matter of reference state, suggesting that the reference state is determined by the tendency of the material to develop, or not develop, axial stress (in excess of the applied prestress) when subjected to torsion at constant axial strain. Our experiments and analysis also strengthen the notion that seemingly distinct animal and plant tissues can have mechanically similar behavior at the quantitative level under certain conditions.
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Affiliation(s)
- T A Engstrom
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - K Pogoda
- Institute for Medicine and Engineering, The University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Institute of Nuclear Physics, Polish Academy of Sciences PL-31342, Krakow, Poland
| | - K Cruz
- Institute for Medicine and Engineering, The University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - P A Janmey
- Institute for Medicine and Engineering, The University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Departments of Physiology and Physics & Astronomy, The University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - J M Schwarz
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
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7
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Walker JT, Beachley G, Amos HM, Baron JS, Bash J, Baumgardner R, Bell MD, Benedict KB, Chen X, Clow DW, Cole A, Coughlin JG, Cruz K, Daly RW, Decina SM, Elliott EM, Fenn ME, Ganzeveld L, Gebhart K, Isil SS, Kerschner BM, Larson RS, Lavery T, Lear GG, Macy T, Mast MA, Mishoe K, Morris KH, Padgett PE, Pouyat RV, Puchalski M, Pye HOT, Rea AW, Rhodes MF, Rogers CM, Saylor R, Scheffe R, Schichtel BA, Schwede DB, Sexstone GA, Sive BC, Sosa Echeverría R, Templer PH, Thompson T, Tong D, Wetherbee GA, Whitlow TH, Wu Z, Yu Z, Zhang L. Toward the improvement of total nitrogen deposition budgets in the United States. Sci Total Environ 2019; 691:1328-1352. [PMID: 31466212 PMCID: PMC7724633 DOI: 10.1016/j.scitotenv.2019.07.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
Frameworks for limiting ecosystem exposure to excess nutrients and acidity require accurate and complete deposition budgets of reactive nitrogen (Nr). While much progress has been made in developing total Nr deposition budgets for the U.S., current budgets remain limited by key data and knowledge gaps. Analysis of National Atmospheric Deposition Program Total Deposition (NADP/TDep) data illustrates several aspects of current Nr deposition that motivate additional research. Averaged across the continental U.S., dry deposition contributes slightly more (55%) to total deposition than wet deposition and is the dominant process (>90%) over broad areas of the Southwest and other arid regions of the West. Lack of dry deposition measurements imposes a reliance on models, resulting in a much higher degree of uncertainty relative to wet deposition which is routinely measured. As nitrogen oxide (NOx) emissions continue to decline, reduced forms of inorganic nitrogen (NHx = NH3 + NH4+) now contribute >50% of total Nr deposition over large areas of the U.S. Expanded monitoring and additional process-level research are needed to better understand NHx deposition, its contribution to total Nr deposition budgets, and the processes by which reduced N deposits to ecosystems. Urban and suburban areas are hotspots where routine monitoring of oxidized and reduced Nr deposition is needed. Finally, deposition budgets have incomplete information about the speciation of atmospheric nitrogen; monitoring networks do not capture important forms of Nr such as organic nitrogen. Building on these themes, we detail the state of the science of Nr deposition budgets in the U.S. and highlight research priorities to improve deposition budgets in terms of monitoring and flux measurements, leaf- to regional-scale modeling, source apportionment, and characterization of deposition trends and patterns.
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Affiliation(s)
- J T Walker
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America.
| | - G Beachley
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - H M Amos
- AAAS Science and Technology Policy Fellow hosted by the U.S. Environmental Protection Agency, Office of Research and Development, Washington, DC, United States of America
| | - J S Baron
- U.S. Geological Survey, Fort Collins Science Center, Fort Collins, CO, United States of America
| | - J Bash
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - R Baumgardner
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - M D Bell
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - K B Benedict
- Colorado State University, Department of Atmospheric Science, Fort Collins, CO, United States of America
| | - X Chen
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - D W Clow
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - A Cole
- Environment and Climate Change Canada, Air Quality Research Division, Toronto, ON, Canada
| | - J G Coughlin
- U.S. Environmental Protection Agency, Region 5, Chicago, IL, United States of America
| | - K Cruz
- U.S. Department of Agriculture, National Institute of Food and Agriculture, Washington, DC, United States of America
| | - R W Daly
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - S M Decina
- University of California, Department of Chemistry, Berkeley, CA, United States of America
| | - E M Elliott
- University of Pittsburgh, Department of Geology & Environmental Science, Pittsburgh, PA, United States of America
| | - M E Fenn
- U.S. Department of Agriculture, Forest Service, Pacific Southwest Research Station, Riverside, CA, United States of America
| | - L Ganzeveld
- Meteorology and Air Quality (MAQ), Wageningen University and Research Centre, Wageningen, Netherlands
| | - K Gebhart
- National Park Service, Air Resources Division, Fort Collins, CO, United States of America
| | - S S Isil
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - B M Kerschner
- Prairie Research Institute, University of Illinois, Champaign, IL, United States of America
| | - R S Larson
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI, United States of America
| | - T Lavery
- Environmental Consultant, Cranston, RI, United States of America
| | - G G Lear
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - T Macy
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - M A Mast
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - K Mishoe
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - K H Morris
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - P E Padgett
- U.S. Department of Agriculture, Forest Service, Pacific Southwest Research Station, Riverside, CA, United States of America
| | - R V Pouyat
- U.S. Forest Service, Bethesda, MD, United States of America
| | - M Puchalski
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - H O T Pye
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - A W Rea
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - M F Rhodes
- D&E Technical, Urbana, IL, United States of America
| | - C M Rogers
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - R Saylor
- National Oceanic and Atmospheric Administration, Air Resources Laboratory, Oak Ridge, TN, United States of America
| | - R Scheffe
- U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Durham, NC, United States of America
| | - B A Schichtel
- National Park Service, Cooperative Institute for Research in the Atmosphere, Colorado State University, Fort Collins, CO, United States of America
| | - D B Schwede
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - G A Sexstone
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - B C Sive
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - R Sosa Echeverría
- Centro de Ciencias de la Atmosfera, Universidad Nacional Autónoma de México, Mexico
| | - P H Templer
- Boston University, Department of Biology, Boston, MA, United States of America
| | - T Thompson
- AAAS Science and Technology Policy Fellow hosted by the U.S. Environmental Protection Agency, Office of Policy, Washington, DC, United States of America
| | - D Tong
- George Mason University. National Oceanic and Atmospheric Administration, Air Resources Laboratory, College Park, MD, United States of America
| | - G A Wetherbee
- U.S. Geological Survey, Hydrologic Networks Branch, Denver, CO, United States of America
| | - T H Whitlow
- Cornell University, Department of Horticulture, Ithaca, NY, United States of America
| | - Z Wu
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - Z Yu
- University of Pittsburgh, Department of Geology & Environmental Science, Pittsburgh, PA, United States of America
| | - L Zhang
- Environment and Climate Change Canada, Air Quality Research Division, Toronto, ON, Canada
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Rafie C, Cruz K, Woolman S, Armstrong T, Jaffee E, Torres ER. Abstract 2352: Epigenetic modulation— unlocking the potential of checkpoint inhibition in advanced breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2352] [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
Immune checkpoint inhibition (ICI) has revolutionized treatment in immunogenic cancers by enabling infiltration of T cells into the tumor microenvironment (TME) and promoting cytotoxic signaling pathways. Tumors with complex immunosuppressive TME’s such as breast cancer present unique therapeutic obstacles as response rates to ICI remain low. Such tumors often recruit myeloid-derived suppressor cells (MDSCs) whose functioning prohibit both T cell activation and infiltration. Our current work aims to uncover the efficacy of ICI in advanced HER2 positive (HER2+) disease and to enhance response rates to these promising therapies by altering the metastatic TME epigenetically. Using a HER-2/neu transgenic mouse model, we syngeneically tumor challenge the NT2.5LM metastatic cell line to evaluate survival outcomes and metastatic burden upon treatment with combinations of the HDAC inhibitor entinostat (ENT), and the checkpoint inhibitors anti-PD-1 and anti-CTLA-4. We show that in the HER2+ mouse model of advanced disease, combining ENT + ICIs improves survival, and ENT + anti-CTLA-4 most significantly improves survival and decreases metastatic burden among responders. By investigating immune changes in sites of metastases, we show that treatment with ENT + ICIs significantly increases infiltration and proliferation of CD8+ T cells, increasing effector T cell infiltration, cytokine production, and markers of activation in cytotoxic T cells in the lung. Flow cytometry, ex vivo co-culture assays, western blots, and other functional assays performed on MDSCs and TIL elucidate further mechanisms behind response. We have found that the metastatic sites of animals treated with ENT + ICIs have significantly decreased infiltration of granulocytic-MDSCs and increased infiltration of monocytic-MDSCs, leading to the apparent cytotoxic anti-tumor response. In mouse models of early stage disease, ENT + ICI therapy alters MDSC infiltration and function in primary tumors, allowing for a more robust adaptive immune response. A significant anti-tumor effect is also seen in the metastatic state, though the function of MDSCs is not consistently altered, suggesting a key mechanism of ENT synergy with ICI to incite immune response and survival benefit that remains to be elucidated. In summary, addition of ICIs to ENT is beneficial in models of advanced disease by altering the recruitment of suppressive cells into the metastatic microenvironment, changing the dynamic interaction of T cells and tumor cells causing a robust anti-tumor response. These novel findings provide insight into how these combination therapies may function in patients with advanced stages of HER2+ breast cancer and suggest that responses are linked to stage of disease and likely follow different mechanisms of action within the different tumor microenvironments.
Citation Format: Christine Rafie, Kayla Cruz, Skylar Woolman, Todd Armstrong, Elizabeth Jaffee, Evanthia Roussos Torres. Epigenetic modulation— unlocking the potential of checkpoint inhibition in advanced breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2352.
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Castro H, Salazar L, Garcia L, Castro Sanchez N, Ramos P, Cruz K. Molecular sub types of breast cancer in a developing country. Classification immunohistochemical: Clinicopathologic feature and survival analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz096.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kirian R, Wang D, Takacs J, Tsai A, Cruz K, Rosello F, Cox K, Hashimura Y, Lembong J, Rowley J, Jung S, Ahsan T. Scaling a xeno-free fed-batch microcarrier suspension bioreactor system from development to production scale for manufacturing XF hMSCs. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ma HS, Poudel B, Torres ER, Sidhom JW, Robinson TM, Christmas B, Scott B, Cruz K, Woolman S, Wall VZ, Armstrong T, Jaffee EM. A CD40 Agonist and PD-1 Antagonist Antibody Reprogram the Microenvironment of Nonimmunogenic Tumors to Allow T-cell-Mediated Anticancer Activity. Cancer Immunol Res 2019; 7:428-442. [PMID: 30642833 DOI: 10.1158/2326-6066.cir-18-0061] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 08/08/2018] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
In cancers with tumor-infiltrating lymphocytes (TILs), monoclonal antibodies (mAbs) that block immune checkpoints such as CTLA-4 and PD-1/PD-L1 promote antitumor T-cell immunity. Unfortunately, most cancers fail to respond to single-agent immunotherapies. T regulatory cells, myeloid derived suppressor cells (MDSCs), and extensive stromal networks within the tumor microenvironment (TME) dampen antitumor immune responses by preventing T-cell infiltration and/or activation. Few studies have explored combinations of immune-checkpoint antibodies that target multiple suppressive cell populations within the TME, and fewer have studied the combinations of both agonist and antagonist mAbs on changes within the TME. Here, we test the hypothesis that combining a T-cell-inducing vaccine with both a PD-1 antagonist and CD40 agonist mAbs (triple therapy) will induce T-cell priming and TIL activation in mouse models of nonimmunogenic solid malignancies. In an orthotopic breast cancer model and both subcutaneous and metastatic pancreatic cancer mouse models, only triple therapy was able to eradicate most tumors. The survival benefit was accompanied by significant tumor infiltration of IFNγ-, Granzyme B-, and TNFα-secreting effector T cells. Further characterization of immune populations was carried out by high-dimensional flow-cytometric clustering analysis and visualized by t-distributed stochastic neighbor embedding (t-SNE). Triple therapy also resulted in increased infiltration of dendritic cells, maturation of antigen-presenting cells, and a significant decrease in granulocytic MDSCs. These studies reveal that combination CD40 agonist and PD-1 antagonist mAbs reprogram immune resistant tumors in favor of antitumor immunity.
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Affiliation(s)
- Hayley S Ma
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bibhav Poudel
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evanthia Roussos Torres
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John-William Sidhom
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tara M Robinson
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian Christmas
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Blake Scott
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kayla Cruz
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Skylar Woolman
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Valerie Z Wall
- Benaroya Research Institute at Virginia Mason, Seattle, Washington
| | - Todd Armstrong
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth M Jaffee
- Department of Oncology, Viragh Center for Pancreatic Clinical Research and Care, Bloomberg Kimmel Institute for Immunotherapy, and the Sidney Kimmel Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland.
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12
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Kinkead HL, Hopkins A, Lutz E, Wu AA, Yarchoan M, Cruz K, Woolman S, Vithayathil T, Glickman LH, Ndubaku CO, McWhirter SM, Dubensky TW, Armstrong TD, Jaffee EM, Zaidi N. Combining STING-based neoantigen-targeted vaccine with checkpoint modulators enhances antitumor immunity in murine pancreatic cancer. JCI Insight 2018; 3:122857. [PMID: 30333318 DOI: 10.1172/jci.insight.122857] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [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: 06/21/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023] Open
Abstract
Tumor neoantigens arising from somatic mutations in the cancer genome are less likely to be subject to central immune tolerance and are therefore attractive targets for vaccine immunotherapy. We utilized whole-exome sequencing, RNA sequencing (RNASeq), and an in silico immunogenicity prediction algorithm, NetMHC, to generate a neoantigen-targeted vaccine, PancVAX, which was administered together with the STING adjuvant ADU-V16 to mice bearing pancreatic adenocarcinoma (Panc02) cells. PancVAX activated a neoepitope-specific T cell repertoire within the tumor and caused transient tumor regression. When given in combination with two checkpoint modulators, namely anti-PD-1 and agonist OX40 antibodies, PancVAX resulted in enhanced and more durable tumor regression and a survival benefit. The addition of OX40 to vaccine reduced the coexpression of T cell exhaustion markers, Lag3 and PD-1, and resulted in rejection of tumors upon contralateral rechallenge, suggesting the induction of T cell memory. Together, these data provide the framework for testing personalized neoantigen-based combinatorial vaccine strategies in patients with pancreatic and other nonimmunogenic cancers.
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Affiliation(s)
- Heather L Kinkead
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alexander Hopkins
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eric Lutz
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Annie A Wu
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Yarchoan
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kayla Cruz
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Skylar Woolman
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teena Vithayathil
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laura H Glickman
- Aduro Biotechnologies Inc., Berkeley, California, USA.,Actym Therapeutics Inc., Berkeley, California, USA
| | | | | | - Thomas W Dubensky
- Aduro Biotechnologies Inc., Berkeley, California, USA.,Tempest Therapeutics, San Francisco, California, USA
| | - Todd D Armstrong
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth M Jaffee
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Neeha Zaidi
- Sidney Kimmel Comprehensive Cancer Center, Skip Viragh Center for Pancreatic Cancer, The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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13
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Adeleye A, Takimoto S, Cruz K, Pasch L, Huddleston H. A randomized double blind clinical trial: building confidence during ovarian stimulation through the love study. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ma HS, Torres ER, Poudel B, Robinson T, Christmas B, Cruz K, Woolman S, Rafie C, Scott B, Wall V, Armstrong T, Jaffee E. Abstract 4936: Combination CD40 agonist and PD-1 antagonist antibody therapy enhances vaccine induced T cell responses in non-immunogenic cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
A hallmark of many non-immunogenic cancers is the lack of tumor infiltrating lymphocytes (TIL) and/or failure to mount a robust anti-tumor T cell response via multiple mechanisms. The presence of T regulatory cells and myeloid derived suppressor cells (MDSCs) serve to dampen the immune response, and furthermore, tumor antigen-specific T cell tolerance limits the efficacy of therapeutic cancer vaccines. CD40 signaling is critical to the decision of whether cytotoxic T lymphocytes become primed or tolerized. Administration of monoclonal CD40 agonistic antibody (Ab) has been shown to promote CD8 activation in vivo, and likely alters the myeloid component of the tumor microenvironment. Our study asks the question of whether combining a T cell inducing vaccine and PD1 inhibition with CD40 agonistic Ab can induce T cell priming and TIL activation in non-immunogenic solid malignancies. We utilized mouse models of pancreatic ductal adenocarcinoma (PDAC) and breast cancer to assess the effects of drug combinations on intratumoral immune responses. Tumor-bearing mice were treated with a GM-CSF secreting vaccine (GVAX) + anti-PD1 Ab alone or in combination with CD40 Ab, or isotype control Ab, and monitored for survival. A separate cohort of mice were analyzed by immunohistochemistry and multi-color flow cytometry to assess T cell infiltration/activation and myeloid maturation. In a hemisplenectomy model of PDAC in which tumor cells were surgically implanted into wild-type recipients, mice treated with isotype control Abs succumbed to disease with extensive liver and peritoneal metastases at 35-70 days. GVAX + anti-PD1 Ab treatment displayed some efficacy, although 70% of mice eventually developed fatal liver metastases. In contrast, CD40 Ab was highly active, with 90% long-term survival afforded by a single administration of Ab, and mice treated with GVAX + anti-PD1 Ab + CD40 Ab had 100% survival. Similar trends in treatment efficacy were observed following subcutaneous tumor implantation of PDAC tumor cells in the lower limb. In an orthotopic model in which HER2/neu-expressing breast tumor cells were implanted into the mammary fat pad of syngeneic neu-N mice, we demonstrated delayed tumor progression and increased median survival in mice treated with GVAX + anti-PD1 Ab + CD40 Ab relative to either therapy alone. Further characterization of immune populations was carried out by high dimensional flow cytometric analysis utilizing PhenoGraph clustering and visualized by t-SNE. Changes were observed in monocytic and dendritic cell infiltration and maturation in the tumors of combination-treated mice. A significant decrease in granulocytic MDSCs was associated with response, as well as an increase in mature antigen presenting cells. In conclusion, GVAX, anti-PD1 and CD40 agonist Ab have potential synergy in modulating anti-tumor immunity in non-immunogenic cancers.
Citation Format: Hayley S. Ma, Evanthia Roussos Torres, Bibhav Poudel, Tara Robinson, Brian Christmas, Kayla Cruz, Skylar Woolman, Christine Rafie, Blake Scott, Valerie Wall, Todd Armstrong, Elizabeth Jaffee. Combination CD40 agonist and PD-1 antagonist antibody therapy enhances vaccine induced T cell responses in non-immunogenic cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4936.
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Affiliation(s)
- Hayley S. Ma
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Bibhav Poudel
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | - Tara Robinson
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Kayla Cruz
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | - Skylar Woolman
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Blake Scott
- 1Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valerie Wall
- 2Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Todd Armstrong
- 1Johns Hopkins University School of Medicine, Baltimore, MD
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Leszczyńska K, Namiot A, Cruz K, Byfield FJ, Won E, Mendez G, Sokołowski W, Savage PB, Bucki R, Janmey PA. Potential of ceragenin CSA-13 and its mixture with pluronic F-127 as treatment of topical bacterial infections. J Appl Microbiol 2010; 110:229-38. [PMID: 20961363 DOI: 10.1111/j.1365-2672.2010.04874.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS Ceragenin CSA-13 is a synthetic mimic of cationic antibacterial peptides, with facial amphiphilic morphology reproduced using a cholic acid scaffold. Previous data have shown that this molecule displays broad-spectrum antibacterial activity, which decreases in the presence of blood plasma. However, at higher concentrations, CSA-13 can cause lysis of erythrocytes. This study was designed to assess in vitro antibacterial and haemolytic activity of CSA-13 in the presence of pluronic F-127. METHODS AND RESULTS CSA-13 bactericidal activity against clinical strains of bacteria associated with topical infections and in an experimental setting relevant to their pathophysiological environment, such as various epithelial tissue fluids and the airway sputum of patients suffering from cystic fibrosis (CF), was evaluated using minimum inhibitory and minimum bactericidal concentration (MIC/MBC) measurements and bacterial killing assays. We found that in the presence of pluronic F-127, CSA-13 antibacterial activity was only slightly decreased, but CSA-13 haemolytic activity was significantly inhibited. CSA-13 exhibits bacterial killing activity against clinical isolates of Staphylococcus aureus, including methicillin-resistant strains, Pseudomonas aeruginosa present in CF sputa, and biofilms formed by different Gram (+) and Gram (-) bacteria. CSA-13 bactericidal action is partially compromised in the presence of plasma, but is maintained in ascites, cerebrospinal fluid, saliva, and bronchoalveolar lavage fluid. The synergistic action of CSA-13, determined by the use of a standard checkerboard assay, reveals an increase in CSA-13 antibacterial activity in the presence of host defence molecules such as the cathelicidin LL-37 peptide, lysozyme, lactoferrin and secretory phospholipase A (sPLA). CONCLUSION These results suggest that CSA-13 may be useful to prevent and treat topical infection. SIGNIFICANCE AND IMPACT OF THE STUDY Combined application of CSA-13 with pluronic F-127 may be beneficial by reducing CSA-13 toxicity.
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Affiliation(s)
- K Leszczyńska
- Department of Diagnostic Microbiology, Medical University of Białystok, Białystok, Poland
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Abstract
The pulmonary artery catheter is an invasive hemodynamic monitor that can provide diagnostic information in situations where history and physical examination are inconclusive. Assisting the physician in therapeutic decisions has added to its clinical value. Understanding the information it provides and making thoughtful therapeutic decisions lie at the core of its use. Despite its use, the PA catheter has been the center of great controversy. Clearly the paucity of prospective randomized trials proving its efficacy is alarming. The inability of physicians to interpret the provided data properly is also unacceptable. Although instituting a moratorium on its use may be extreme, limiting its use to approved indications seems more appropriate. In the future, ready availability of other less invasive methods such as echocardiography may allow clinicians to become less reliant on the PA catheter. Until then, clinicians would be served best by comprehending the intricacies and the limitations of this sophisticated instrument.
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Affiliation(s)
- K Cruz
- Section of Cardiology, Rush-St. Luke's Medical Center, 1725 W. Harrison Street, Chicago, IL 60612, USA
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Abstract
The future of pediatric psychopharmacology will be a collaborative effort among the public, the federal government, the pharmaceutical industry, and clinical scientists. Clinical scientists and the NIH have initiated the process. The federal regulatory guidelines are in place but may need to be amended further to truly facilitate needed research. The pharmaceutical industry is making efforts to study medications in childhood psychiatric disorders. More new drugs are being tested in humans. Many of the new agents offer the promise of more clinical benefit with milder side effects. The future is indeed promising.
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Affiliation(s)
- J T Walkup
- Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
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Güriş D, Auerbach SB, Vitek C, Maes E, McCready J, Durand M, Cruz K, Iohp K, Haddock R, Rota J, Rota P, Heath J, Redd SC. Measles outbreaks in Micronesia, 1991 to 1994. Pediatr Infect Dis J 1998; 17:33-9. [PMID: 9469392 DOI: 10.1097/00006454-199801000-00008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several islands in Micronesia experienced large measles outbreaks, during 1991 through 1994. Except for Guam, none of the islands had reported measles outbreaks during the previous 20 years. METHODS To characterize the outbreaks, measles surveillance data, hospital records and death certificates were reviewed. Preoutbreak vaccination coverage rates were assessed by reviewing public health vaccination records. Viral isolates were genetically sequenced to determine the source of transmission. Linear regression analysis was performed to assess the effectiveness of outbreak control measures. RESULTS Between 1991 and 1994 more than 1300 measles cases and 16 measles-related deaths were reported in Micronesia. Preoutbreak vaccination coverage rates among 2-year-old children were 55 to 94%. Genetic sequencing of the viral isolates and epidemiologic investigations suggested transmission between islands and new importations from outside of Micronesia. The highest attack rates were among children ages < 5 years (20/1000) and 10 to 19 years (38/1000). Compared with attack rates among children ages < 1 and 10 to 19 years, attack rates were lower among those ages 5 to 9 years, in whom 2-dose vaccination coverage rates were highest (P < 0.001). Early and rapid implementation of mass vaccination campaigns was significantly associated with shorter duration of outbreaks (P = 0.049). CONCLUSION The measles outbreaks in Micronesia show that island populations may be highly susceptible to measles. High two-dose vaccination coverage levels must be maintained to prevent such outbreaks. Early and rapidly implemented mass measles vaccination campaigns were effective in control of island outbreaks. Strengthening public health infrastructure and surveillance is necessary for early identification of outbreaks and rapid implementation of mass campaigns.
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Affiliation(s)
- D Güriş
- National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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