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Hayne D, Ong K, Swarbrick N, McCombie SP, Moe A, Hawks C, Viswambaram P, Conduit C, Liow E, Spalding L, Lim J, Ferguson T, Meehan K, Davis ID, Redfern AD. The SUB-urothelial DUrvalumab InjEction-1 (SUBDUE-1) trial: first-in-human trial in patients with bladder cancer. BJU Int 2024. [PMID: 38469652 DOI: 10.1111/bju.16325] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
OBJECTIVES To assess the safety of sub-urothelial injection of durvalumab and examine the impact on tissue and circulating immune cell populations. PATIENTS AND METHODS The patients were chemotherapy and immunotherapy naïve (bacille Calmette-Guérin allowed) with non-metastatic muscle-invasive bladder cancer or non-muscle-invasive bladder cancer planned for radical cystectomy (RC). The study was a Phase Ib 3 + 3 dose-escalation design with sub-urothelial injection of durvalumab at three pre-determined doses (25, 75, 150 mg) diluted in 25 mL normal saline, injected at 25 locations (25 × 1 mL injections), at least 2 weeks before RC. RESULTS A total of 11 patients were recruited (10 male, one female). No significant changes were reported on American Urological Association Symptom Score or O'Leary Interstitial Cystitis Scale. In all, 14 adverse events (AEs) were reported (10 Grade 1, three Grade 2, one Grade 3), none considered immune-related. No Grade 4 or 5 AEs were recorded. All the patients underwent RC. Tissue immune populations changed following durvalumab injection (P = 0.012), with a statistically significant increase in M2-macrophage (CD163) when comparing the 25-150 mg dose (P = 0.021). Basal/mixed cancers showed a larger CD163 increase than luminal cancers (P = 0.033). CONCLUSION Sub-urothelial injection of durvalumab is feasible and safe without immune-related AEs and shows local immunological effects.
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Affiliation(s)
- Dickon Hayne
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Katherine Ong
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Nicole Swarbrick
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Steve P McCombie
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Andrew Moe
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Cynthia Hawks
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Pravin Viswambaram
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Ciara Conduit
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Medical Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Elizabeth Liow
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Lisa Spalding
- Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
- University of Western Australia Centre for Medical Research, Nedlands, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Jayne Lim
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Thomas Ferguson
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Katie Meehan
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
| | - Ian D Davis
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
- Monash University, Melbourne, Victoria, Australia
- Eastern Health, Melbourne, Victoria, Australia
| | - Andrew D Redfern
- UWA Medical School, University of Western Australia, Crawley, Western Australia, Australia
- South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, New South Wales, Australia
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Lasagna A, Sacchi P. The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management. Cancers (Basel) 2024; 16:795. [PMID: 38398187 PMCID: PMC10886483 DOI: 10.3390/cancers16040795] [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: 11/16/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Immune-mediated hepatotoxicity (IMH) is not-so-rare complication during treatment with immune checkpoint inhibitors (ICIs). This narrative review aims to report the current knowledge on hepatic immune-related adverse events (irAEs) during immunotherapy from pathogenesis to multidisciplinary management. The majority of cases of IMH are asymptomatic and only a few patients may have clinical conditions. The severity of IMH is usually stratified according to Common Terminology for Clinical Adverse Events (CTCAE) criteria, but these scores may overestimate the clinical severity of IMH compared to the Drug-Induced Liver Injury Network (DILIN) scale. The differential diagnosis of IMH is challenging because the elevated liver enzymes can be due to a number of etiologies such as viral infection, autoimmune and metabolic diseases, liver metastases, biliary diseases, and other drugs. The cornerstones of IMH management are represented by withholding or delaying ICI administration and starting immunosuppressive therapy. A multidisciplinary team, including oncologists, hepatologists, internists, and emergency medicine physicians, is essential for the management of IMH.
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Affiliation(s)
- Angioletta Lasagna
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Paolo Sacchi
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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Villalobos A, Dabbous HH, Little O, Gbolahan OB, Akce M, Lilly MA, Bercu Z, Kokabi N. Safety and Efficacy of Concurrent Atezolizumab/Bevacizumab or Nivolumab Combination Therapy with Yttrium-90 Radioembolization of Advanced Unresectable Hepatocellular Carcinoma. Curr Oncol 2023; 30:10100-10110. [PMID: 38132368 PMCID: PMC10742675 DOI: 10.3390/curroncol30120734] [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: 10/01/2023] [Revised: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 12/23/2023] Open
Abstract
To evaluate the safety and efficacy of combining yttrium-90 radioembolization (Y90-RE) with immune checkpoint inhibitor therapy, consecutive advanced unresectable hepatocellular carcinoma (HCC) patients treated between 2016 and 2022 with atezolizumab/bevacizumab or nivolumab within three-months pre- and post-Y90-RE were retrospectively evaluated. Tumor response and treatment-related clinical/laboratory adverse events (AE) were assessed at 1 and 6 months, as well as differences in clinical and laboratory variables and median overall survival (OS) from initial treatment (whether it was Y90-RE or systemic therapy) between the two cohorts. A total of 19 patients (10 atezolizumab/bevacizumab; 9 nivolumab), comprising 84% males with median age 69 years, met the inclusion criteria. Compared to the atezolizumab/bevacizumab group, there were less males (100% vs. 67%; p = 0.02) and more ECOG ≥ 2 patients in the nivolumab group (0% vs. 33%; p = 0.02). Baseline characteristics or incidence of 6-month post-treatment any-grade AE (60% vs. 56%; p = 0.7), grade ≥ 3 AE (0% vs. 11%; p = 0.3), objective response (58% total, 60% vs. 56%; p = 0.7), and complete response (16% total; 10% vs. 22%; p = 0.8) were similar between the atezolizumab/bevacizumab and the nivolumab cohorts. Median OS was 12.9 months for the whole cohort, 16.4 months for nivolumab, and 10.7 months for atezolizumab/bevacizumab. Among patients with advanced unresectable HCC, the utilization of Y90-RE concurrently or within 90 days of nivolumab or atezolizumab/bevacizumab immunotherapy, appears to be well-tolerated and with a low incidence of severe AE.
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Affiliation(s)
- Alexander Villalobos
- Department of Radiology, University of North Carolina at Chapel Hill, Alexander Villalobos 101 Manning Drive, Chapel Hill, NC 27514, USA;
| | - Howard Hussein Dabbous
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (H.H.D.); (M.A.L.); (Z.B.)
| | - Olivia Little
- Department of Radiology and Imaging Sciences, Mercer University School of Medicine, Savannah, GA 31404, USA;
| | - Olumide Babajide Gbolahan
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Mehmet Akce
- Department of Hematology and Medical Oncology, University of Alabama School of Medicine, Birmingham, AL 35294, USA;
| | - Meghan Allegra Lilly
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (H.H.D.); (M.A.L.); (Z.B.)
| | - Zachary Bercu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (H.H.D.); (M.A.L.); (Z.B.)
| | - Nima Kokabi
- Department of Radiology, University of North Carolina at Chapel Hill, Alexander Villalobos 101 Manning Drive, Chapel Hill, NC 27514, USA;
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Carmona-Rocha E, Aguado M, Tubau C, Sánchez S, Mozos A, Sullivan I, Spertino J. Epidermolysis bullosa acquisita ausgelöst durch Atezolizumab. J Dtsch Dermatol Ges 2023; 21:1407-1409. [PMID: 37946658 DOI: 10.1111/ddg.15203_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/09/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Elena Carmona-Rocha
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Aguado
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carla Tubau
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sofía Sánchez
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Anna Mozos
- Anatomical Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ivana Sullivan
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Spertino
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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5
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Carmona-Rocha E, Aguado M, Tubau C, Sánchez S, Mozos A, Sullivan I, Spertino J. Epidermolysis bullosa acquisita induced by atezolizumab. J Dtsch Dermatol Ges 2023; 21:1407-1409. [PMID: 37658659 DOI: 10.1111/ddg.15203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/09/2023] [Indexed: 09/03/2023]
Affiliation(s)
- Elena Carmona-Rocha
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Aguado
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carla Tubau
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sofía Sánchez
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Anna Mozos
- Anatomical Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ivana Sullivan
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Spertino
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Al-Batran SE, Mueller DW, Rafiyan MR, Kiselicki D, Atmaca A, Habibzada T, Mueller C, Brignone C, Triebel F, Loose M, Schaaf M, Sookthai D, Eickhoff R, Jaeger E, Goetze TO. A soluble LAG-3 protein (eftilagimod alpha) and an anti-PD-L1 antibody (avelumab) tested in a phase I trial: a new combination in immuno-oncology. ESMO Open 2023; 8:101623. [PMID: 37742484 PMCID: PMC10594027 DOI: 10.1016/j.esmoop.2023.101623] [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: 06/26/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Eftilagimod alpha (efti) is a major histocompatibility complex class II agonist activating antigen-presenting cells which leads to greater systemic type 1 T helper response and more cytotoxic CD8+ T-cell activation. This phase I trial evaluated the administration of efti, a soluble lymphocyte activation gene-3 (LAG-3) protein, combined with the anti-programmed death-ligand 1 (PD-L1) antibody avelumab in advanced solid tumors. PATIENTS AND METHODS Patients with heavily pretreated metastatic solid tumors received intravenous avelumab (800 mg) combined with subcutaneously administered efti (6 or 30 mg) for up to 12 cycles, followed by avelumab monotherapy. The primary endpoint was the assessment of the recommended phase II dose (RP2D) of efti in combination with avelumab. RESULTS Twelve patients with different tumor entities were enrolled (six patients in each cohort). During treatment, no dose-limiting toxicities occurred, and the severity of most adverse events was grade 1 or 2. In total, nine serious adverse events were documented, resulting in a fatal outcome in two cases, but none of them were assessed to be treatment related. Five patients (42%) achieved partial response. The median progression-free survival was 1.96 months and the median overall survival was not reached, with a 12-month survival rate of 75%. CONCLUSION Subcutaneously administered efti plus avelumab was well tolerated, and efti of 30 mg was determined to be RP2D. The activity is promising and warrants further investigation in future phase II trials.
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Affiliation(s)
- S-E Al-Batran
- UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main; Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.
| | - D W Mueller
- Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
| | - M-R Rafiyan
- Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main
| | - D Kiselicki
- Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main
| | - A Atmaca
- Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main
| | - T Habibzada
- UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main
| | | | | | | | - M Loose
- Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
| | - M Schaaf
- Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
| | - D Sookthai
- Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
| | - R Eickhoff
- Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
| | - E Jaeger
- Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main
| | - T O Goetze
- UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main; Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main
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Scarpa JR, Montagna G, Plitas G, Gulati A, Fischer GW, Mincer JS. Opioids and immune checkpoint inhibitors differentially regulate a common immune network in triple-negative breast cancer. Front Oncol 2023; 13:1267532. [PMID: 37781176 PMCID: PMC10539607 DOI: 10.3389/fonc.2023.1267532] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Background Opioids are the primary analgesics for cancer pain. Recent clinical evidence suggests opioids may counteract the effect of immune checkpoint inhibition (ICI) immunotherapy, but the mechanism for this interaction is unknown. The following experiments study how opioids and immunotherapy modulate a common RNA expression pathway in triple negative breast cancer (TNBC), a cancer subtype in which immunotherapy is increasingly used. This study identifies a mechanism by which opioids may decrease ICI efficacy, and compares ketamine, a non-opioid analgesic with emerging use in cancer pain, for potential ICI interaction. Methods Tumor RNA expression and clinicopathologic data from a large cohort with TNBC (N=286) was used to identify RNA expression signatures of disease. Various drug-induced RNA expression profiles were extracted from multimodal RNA expression datasets and analyzed to estimate the RNA expression effects of ICI, opioids, and ketamine on TNBC. Results We identified a RNA expression network in CD8+ T-cells that was relevant to TNBC pathogenesis and prognosis. Both opioids and anti-PD-L1 ICI regulated RNA expression in this network, suggesting a nexus for opioid-ICI interaction. Morphine and anti-PD-L1 therapy regulated RNA expression in opposing directions. By contrast, there was little overlap between the effect of ketamine and anti-PD-L1 therapy on RNA expression. Conclusions Opioids and ICI may target a common immune network in TNBC and regulate gene expression in opposing fashion. No available evidence supports a similar interaction between ketamine and ICI.
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Affiliation(s)
- Joseph R. Scarpa
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States
| | - Giacomo Montagna
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - George Plitas
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Amitabh Gulati
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gregory W. Fischer
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Joshua S. Mincer
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Topalian SL, Forde PM, Emens LA, Yarchoan M, Smith KN, Pardoll DM. Neoadjuvant immune checkpoint blockade: A window of opportunity to advance cancer immunotherapy. Cancer Cell 2023; 41:1551-1566. [PMID: 37595586 PMCID: PMC10548441 DOI: 10.1016/j.ccell.2023.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/09/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023]
Abstract
Among new treatment approaches for patients with cancer, few have accelerated as quickly as neoadjuvant immune checkpoint blockade (ICB). Neoadjuvant cancer therapy is administered before curative-intent surgery in treatment-naïve patients. Conventional neoadjuvant chemotherapy and radiotherapy are primarily intended to reduce tumor size, improving surgical resectability. However, recent scientific evidence outlined here suggests that neoadjuvant immunotherapy can expand and transcriptionally modify tumor-specific T cell clones to enhance both intratumoral and systemic anti-tumor immunity. It further offers a unique "window of opportunity" to explore mechanisms and identify novel biomarkers of ICB response and resistance, opening possibilities for refining long-term clinical outcome predictions and developing new, more highly effective ICB combination therapies. Here, we examine advances in clinical and scientific knowledge gleaned from studies in select cancers and describe emerging key principles relevant to neoadjuvant ICB across many cancer types.
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Affiliation(s)
- Suzanne L Topalian
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Patrick M Forde
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | | | - Mark Yarchoan
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kellie N Smith
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Drew M Pardoll
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Villa-Ruano N, Marin-Cevada V, Sanchez-Esgua G, Villafaña-Diaz L, Perez-Santos M. Drug repurposing of rimantadine for treatment of cancer. Pharm Pat Anal 2023; 12:231-236. [PMID: 37982658 DOI: 10.4155/ppa-2023-0019] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Repurposing of approved drugs allows strong savings in time and investment. Rimantadine is an FDA-approved drug for prevention and treatment of influenza A infection. Patent US2021330605 describes the use of rimantadine, an adamantane derivative, for the treatment of melanoma, breast cancer and head and neck squamous cell carcinoma. Rimantadine inhibited proliferation of cell lines of melanoma, breast cancer, and head and neck squamous cell carcinoma, increased the survival of mice injected with cancer cell lines and restores the expression of MHC class I. Rimantadine has the potential to be used successfully in the treatment of head and neck squamous cell carcinoma.
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Affiliation(s)
- Nemesio Villa-Ruano
- Dirección de Innovación y Transferencia de Conocimiento, Benemérita Universidad Autónoma de Puebla, Puebla, CP, 72570, México
- Consejo Nacional de Ciencia y Tecnología, Cátedras, CONACYT, México
| | - Vianey Marin-Cevada
- Laboratorio de Ecología Molecular Microbiana, Centro de Investigaciones en Ciencias Microbiológicas, Benemérita Universidad Autónoma de Puebla, Puebla, CP, 72570, México
| | - Gabriela Sanchez-Esgua
- Dirección de Innovación y Transferencia de Conocimiento, Benemérita Universidad Autónoma de Puebla, Puebla, CP, 72570, México
| | - Luis Villafaña-Diaz
- Posgrado en Planeación Estratégica y Dirección Tecnológica, Universidad Popular Autónoma del Estado de Puebla, Puebla, CP, 72410, México
| | - Martin Perez-Santos
- Dirección de Innovación y Transferencia de Conocimiento, Benemérita Universidad Autónoma de Puebla, Puebla, CP, 72570, México
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Olivares-Hernández A, González del Portillo E, Tamayo-Velasco Á, Figuero-Pérez L, Zhilina-Zhilina S, Fonseca-Sánchez E, Miramontes-González JP. Immune checkpoint inhibitors in non-small cell lung cancer: from current perspectives to future treatments-a systematic review. Ann Transl Med 2023; 11:354. [PMID: 37675322 PMCID: PMC10477621 DOI: 10.21037/atm-22-4218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/12/2023] [Indexed: 09/08/2023]
Abstract
Background The introduction of immunotherapy in the treatment of non-small cell lung cancer (NSCLC) has resulted in a radical change in patients' treatment responses and survival rates. The increased percentage of long survivors, improved toxicity profiles compared to chemotherapy, and the possible applications for different NSCLC scenarios, have led to immune checkpoint inhibitors (ICIs) becoming the cornerstone of NSCLC treatment. Therefore, the objective of this review is to describe the current and future perspectives of NSCLC treatment. Methods A systematic review according to the PRISMA criteria has been performed based on clinical trials with immunotherapy in NSCLC from the start of these treatments until June 2022. Results The use of ICIs is widespread across both first- and second-line treatments with anti-PD-1, anti-PD-L1, and anti-CTLA-4 drugs. New indications for immunotherapy in NSCLC have focused on adjuvant (atezolizumab) and neoadjuvant (nivolumab), with ICIs now present in all stages of NSCLC treatment. Given the promising results seen in clinical trials, new ICIs [anti- lymphocyte activation gene-3 (LAG-3) or IDO1] currently under development, will soon be used as standard treatment for NSCLC. Conclusions Immunotherapy is the mainstay of NSCLC treatment in all stages, including adjuvant, neoadjuvant and advanced tumors. The development of new molecules will revolutionize the treatment of NSCLC in the coming years.
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Affiliation(s)
- Alejandro Olivares-Hernández
- Department of Medical Oncology, University Hospital of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | | | | | - Luis Figuero-Pérez
- Department of Medical Oncology, University Hospital of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | | | - Emilio Fonseca-Sánchez
- Department of Medical Oncology, University Hospital of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - José Pablo Miramontes-González
- Department of Internal Medicine, University Hospital Rio Hortega, Valladolid, Spain
- Faculty of Medicine, University of Valladolid, Valladolid, Spain
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Abstract
Therapeutic cancer vaccines have been vigorously sought to bolster host adaptive immunity against metastatic cancers, but tumor heterogeneity, ineffective antigen utilization, and immunosuppressive tumor microenvironment hinder their clinical applications. Autologous antigen adsorbability and stimulus-release carrier coupling with immunoadjuvant capacity are urgent for personalized cancer vaccines. Here, we propose a perspective strategy of using a multipotent gallium-based liquid metal (LM) nanoplatform for personalized in situ cancer vaccines (ISCVs). The antigen-capturing and immunostimulatory LM nanoplatform can not only effectively destroy orthotopic tumors to generate multifarious autologous antigens upon external energy stimulation (photothermal/photodynamic effect) but also capture and transport antigens into dendritic cells (DCs) to enhance antigen utilization (adequate DCs uptake, antigen-endo/lysosomal escape) and facilitate DCs activation (mimic alum immunoadjuvant capacity), which ultimately awaken systemic antitumor immunity (expand cytotoxic T lymphocytes and modulate tumor microenvironment). With immune checkpoint blockade (anti-PD-L1) to further relieve the immunosuppressive tumor microenvironment, the positive tumoricidal immunity feedback loop was established to effectively eliminate orthotopic tumors, inhibit abscopal tumor growth, relapse, and metastasis as well as tumor-specific prevention. Collectively, this study demonstrates the potential of a multipotent LM nanoplatform for personalized ISCVs, which will open frontier exploration of LM-based immunostimulatory biomaterials and may encourage further investigation of precise individualized immunotherapy.
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Affiliation(s)
- Dawei Wang
- Liquid Metal and Cryogenic Biomedical Research Center, Beijing Key Lab of CryoBiomedical Engineering and Key Lab of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhongyang Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Yuxia Qi
- Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Kaiwen Hu
- Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Tian Zhou
- Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Jing Liu
- Liquid Metal and Cryogenic Biomedical Research Center, Beijing Key Lab of CryoBiomedical Engineering and Key Lab of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Wei Rao
- Liquid Metal and Cryogenic Biomedical Research Center, Beijing Key Lab of CryoBiomedical Engineering and Key Lab of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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12
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Wei JQ, Yuile A, Itchins M, Kong BY, Li BT, Pavlakis N, Chan DL, Clarke SJ. Anti-PD-1 Monoclonal Antibodies (mAbs) Are Superior to Anti-PD-L1 mAbs When Combined with Chemotherapy in First-Line Treatment for Metastatic Non-Small Cell Lung Cancer (mNSCLC): A Network Meta-Analysis. Biomedicines 2023; 11:1827. [PMID: 37509467 PMCID: PMC10376908 DOI: 10.3390/biomedicines11071827] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Platinum-based chemotherapy combined with anti-PD-1 or PD-L1 monoclonal antibodies (mAbs) is now standard first-line therapy for mNSCLC patients without sensitizing driver mutations. Anti-PD-1 and anti-PD-L1 mAbs are considered to be equivalent in efficacy. In the absence of head-to-head randomized control trials (RCTs), we utilized network meta-analysis (NWM) to provide an indirect comparison of their efficacy. A systematic literature review and NWM were performed using RCTs that investigated anti-PD-1 or PD-L1 mAbs ± chemotherapy in patients with mNSCLC in the first-line setting. The primary outcome was comparative overall survival (OS), while secondary outcomes were comparative progression-free survival (PFS), objective response rate (ORR), and rate of grade 3 and higher toxicities. We identified 24 RCTs. Patients treated with anti-PD-1 mAb + chemotherapy compared with anti-PD-L1 mAb + chemotherapy showed superior mOS, mPFS, and ORR with a similar rate of grade 3 and higher toxicities. This difference in mOS was most pronounced in the PD-L1 TPS 1-49% population. The two mAbs were equivalent as single agents. Anti-PD-1 mAb + chemotherapy improved mOS when compared to anti-PD-1 mAb monotherapy, whereas anti-PD-L1 mAbs + chemotherapy did not when compared to anti-PD-L1 mAb monotherapy. Head-to-head RCTs are warranted in the future.
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Affiliation(s)
- Joe Q. Wei
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - Alexander Yuile
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - Malinda Itchins
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - Benjamin Y. Kong
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - Bob T. Li
- Memorial Sloan Kettering Cancer Centre, Weill Cornell Medical College, New York, NY 10065, USA
| | - Nick Pavlakis
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - David L. Chan
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
| | - Stephen J. Clarke
- Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia
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13
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Wan R, Guo Y, Hao X, Wang Z, Duan J, Wang J. Efficacy and safety of nab-paclitaxel or combined nab-paclitaxel and immune checkpoint inhibitors in relapsed small-cell lung cancer. Ther Adv Med Oncol 2023; 15:17588359231179315. [PMID: 37389188 PMCID: PMC10302613 DOI: 10.1177/17588359231179315] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/11/2023] [Indexed: 07/01/2023] Open
Abstract
Background Most patients with small-cell lung cancer (SCLC) experience disease progression after first-line chemotherapy. Notably, nab-paclitaxel monotherapy has antitumor activity in relapsed SCLC. Objective This study evaluated the efficacy and safety of combined of nab-paclitaxel and immune checkpoint inhibitors (ICIs) in relapsed SCLC. Design We retrospectively analyzed patients with relapsed SCLC who received nab-paclitaxel or combined nab-paclitaxel and ICIs (anti-programmed death-1, PD-1 or anti-programmed cell death 1 ligand, PD-L1) between February 2017 and September 2021. Methods Efficacy and safety data were collected from electronic health records. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method and a standard log-rank test. Results We included 56 patients with relapsed SCLC, of which 29 received nab-paclitaxel alone (Group A), and 27 received combined nab-paclitaxel and ICIs (Group B). Baseline characteristics were similar between the two groups. Group B had a numerically higher objective response rate than Group A (40.7% versus 17.2%; p = 0.052). However, combined nab-paclitaxel and ICIs failed to demonstrate survival superiority over nab-paclitaxel monotherapy [median PFS: 3.2 months versus 2.8 months (p = 0.5225); median OS: 11.0 months versus 9.3 months (p = 0.7298)]. The safety profiles of Groups A and B were both tolerable. Conclusion This study indicated that compared with nab-paclitaxel monotherapy, combined nab-paclitaxel and ICIs failed to improve survival in relapsed SCLC.
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Affiliation(s)
- Rui Wan
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanrong Guo
- Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Xuezhi Hao
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhijie Wang
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianchun Duan
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Wang
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Panjiayuan Nanli N0.17, Beijing, 100021, China
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14
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Paniagua-Herranz L, Doger B, Díaz-Tejeiro C, Sanvicente A, Nieto-Jiménez C, Moreno V, Pérez Segura P, Gyorffy B, Calvo E, Ocana A. Genomic Mapping of Epidermal Growth Factor Receptor and Mesenchymal-Epithelial Transition-Up-Regulated Tumors Identifies Novel Therapeutic Opportunities. Cancers (Basel) 2023; 15:3250. [PMID: 37370859 DOI: 10.3390/cancers15123250] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The identification of proteins in the cellular membrane of the tumoral cell is a key to the design of therapeutic agents. Recently, the bi-specific antibody amivantamab, targeting the oncogenic membrane proteins EGFR and MET, received regulatory approval for the treatment of adult patients with locally advanced or metastatic NSCLC. METHODS The authors interrogated several publicly available genomic datasets to evaluate the expression of both receptors and PD-L1 in most of the solid and hematologic malignancies and focused on prostate adenocarcinoma (PRAD) and pancreatic adenocarcinoma (PAAD). RESULTS In PAAD, EGFR highly correlated with PD-L1 and MET, and MET showed a moderate correlation with PD-L1, while in PRAD, EGFR, MET and PD-L1 showed a strong correlation. In addition, in tumors treated with immune checkpoint inhibitors, including anti-PD(L)1 and anti-CTLA4, a high expression of EGFR and MET predicted detrimental survival. When exploring the relationship of immune populations with these receptors, the authors observed that in PAAD and PRAD, EGFR moderately correlated with CD8+ T cells. Furthermore, EGFR and MET correlated with neutrophils in PRAD. CONCLUSIONS The authors identified tumor types where EGFR and MET were highly expressed and correlated with a high expression of PD-L1, opening the door for the future combination of bi-specific EGFR/MET antibodies with anti-PD(L)1 inhibitors.
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Affiliation(s)
- Lucía Paniagua-Herranz
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
| | - Bernard Doger
- START Madrid-HM Centro Integral Oncológico Clara Campal (CIOCC), Early Phase Program, HM Sanchinarro University Hospital, 28050 Madrid, Spain
| | - Cristina Díaz-Tejeiro
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
| | - Adrián Sanvicente
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
- Facultad de Ciencias Químicas, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Nieto-Jiménez
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
| | - Víctor Moreno
- START Madrid-Fundación Jiménez Díaz (FJD), Early Phase Program, Fundación Jiménez Díaz Hospital, 28040 Madrid, Spain
| | - Pedro Pérez Segura
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
| | - Balazs Gyorffy
- Department of Bioinformatics, Semmelweis University, 1094 Budapest, Hungary
- Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary
- TTK Cancer Biomarker Research Group, Institute of Enzymology, 1117 Budapest, Hungary
| | - Emiliano Calvo
- START Madrid-HM Centro Integral Oncológico Clara Campal (CIOCC), Early Phase Program, HM Sanchinarro University Hospital, 28050 Madrid, Spain
| | - Alberto Ocana
- Experimental Therapeutics in Cancer Unit, Medical Oncology Department, Hospital Clínico San Carlos (HCSC), Instituto de Investigación Sanitaria (IdISSC) and CIBERONC, 28040 Madrid, Spain
- START Madrid-Fundación Jiménez Díaz (FJD), Early Phase Program, Fundación Jiménez Díaz Hospital, 28040 Madrid, Spain
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15
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Raza A, Mohsen R, Kanbour A, Zar Gul AR, Philip A, Vijayakumar S, Hydrose S, Prabhu KS, Al-Suwaidi AK, Inchakalody VP, Merhi M, Abo El-Ella DM, Tauro MA, Akbar S, Al-Bozom I, Abualainin W, Al-Abdulla R, Sirriya SA, Hassnad S, Uddin S, Mohamed Ibrahim MI, Al Homsi U, Demime S. Serum immune mediators as novel predictors of response to anti-PD-1/PD-L1 therapy in non-small cell lung cancer patients with high tissue-PD-L1 expression. Front Immunol 2023; 14:1157100. [PMID: 37256148 PMCID: PMC10225547 DOI: 10.3389/fimmu.2023.1157100] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/13/2023] [Indexed: 06/01/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related morbidity and mortality worldwide. Immune checkpoint inhibitors (ICIs) including anti-PD-1 and anti-PD-L1 antibodies, have significantly changed the treatment outcomes with better overall survival, but only 15-40% of the patients respond to ICIs therapy. The search for predictive biomarkers of responses is warranted for better clinical outcomes. We aim here to identify pre-treatment soluble immune molecules as surrogate biomarkers for tissue PD-L1 (TPD-L1) status and as predictors of response to anti-PD-1/PD-L1 therapy in NSCLC patients. Sera from 31 metastatic NSCLC patients, eligible for anti-PD-1/PD-L1 or combined chemoimmunotherapy, were collected prior to treatment. Analysis of soluble biomarkers with TPD-L1 status showed significant up/down regulation of the immune inhibitory checkpoint markers (sSiglec7, sSiglec9, sULBP4 and sPD-L2) in patients with higher TPD-L1 (TPD-L1 >50%) expression. Moreover, correlation analysis showed significant positive linear correlation of soluble PD-L1 (sPD-L1) with higher TPD-L1 expression. Interestingly, only responders in the TPD-L1 >50% group showed significant down regulation of the immune inhibitory markers (sPD-L2, sTIMD4, sNectin2 and CEA). When responders vs. non-responders were compared, significant down regulation of other immune inhibitory biomarkers (sCD80, sTIMD4 and CEA) was recorded only in responding patients. In this, the optimal cut-off values of CD80 <91.7 pg/ml and CEA <1614 pg/ml were found to be significantly associated with better progression free survival (PFS). Indeed, multivariate analysis identified the cutoff-value of CEA <1614 pg/ml as an independent predictor of response in our patients. We identified here novel immune inhibitory/stimulatory soluble mediators as potential surrogate/predictive biomarkers for TPD-L1 status, treatment response and PFS in NSCLC patients treated with anti-PD-1/PD-L1 therapy.
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Affiliation(s)
- Afsheen Raza
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Reyad Mohsen
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Aladdin Kanbour
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Abdul Rehman Zar Gul
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Anite Philip
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Suma Vijayakumar
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Shereena Hydrose
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Kirti S. Prabhu
- Translational Research Institute (TRI), Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Aisha Khamis Al-Suwaidi
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Varghese Philipose Inchakalody
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Maysaloun Merhi
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Dina M. Abo El-Ella
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | | | - Shayista Akbar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Issam Al-Bozom
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Wafa Abualainin
- Diagnostic Genomic Division , Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Rajaa Al-Abdulla
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Shaza Abu Sirriya
- Diagnostic Genomic Division , Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Suparna Hassnad
- Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Shahab Uddin
- Translational Research Institute and Dermatology Institute, Academic Health System, Hamad, Medical Corporation, Doha, Qatar
- Laboratory Animal Research Center, Qatar University, Doha, Qatar
| | - Mohamed Izham Mohamed Ibrahim
- Clinical Pharmacy and Practice Department, College of Pharmacy, Qatar University (QU) Health, Qatar University, Doha, Qatar
| | - Ussama Al Homsi
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Said Demime
- Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Translational Cancer Research Facility, Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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16
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Morris VK, Jazaeri A, Westin SN, Pettaway C, George S, Huey RW, Grinsfelder M, Shafer A, Johnson B, Vining D, Guo M, Fellman B, Frumovitz M. Phase II Trial of MEDI0457 and Durvalumab for Patients With Recurrent/Metastatic Human Papillomavirus-Associated Cancers. Oncologist 2023:7146114. [PMID: 37104874 DOI: 10.1093/oncolo/oyad085] [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: 08/08/2022] [Accepted: 03/09/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) types 16/18 drive oncogenesis for most patients with cervical, anal, and penile cancers. MEDI0457, a therapeutic DNA vaccine containing plasmids for E6 and E7 HPV-16/18 viral oncogenes and IL-12 adjuvant, is safe and provokes an immune response against E6/E7. We tested MEDI0457 with the anti-PD-L1 antibody durvalumab for patients with HPV-associated cancers. METHODS Patients with recurrent/metastatic, treatment-refractory HPV-16/18 cervical cancer, or rare HPV-associated (anal and penile) cancers were eligible. Prior immune checkpoint inhibition was not permitted. Patients received MEDI0457 7 mg intramuscularly (weeks 1, 3, 7, 12, and every 8 weeks thereafter) and durvalumab 1500 mg intravenously every 4 weeks. The primary endpoint was overall response (RECIST 1.1). In this Simon two-stage phase 2 trial (Ho: p < 0.15; Ha: p ≥ 0.35), ≥2 responses were needed in both cervical and non-cervical cohorts during the first stage for the trial to proceed to stage 2 with an additional 25 patients (34 total) enrolled. RESULTS Twenty-one patients (12 cervical, 7 anal, and 2 penile) were evaluable for toxicity and 19 for response Overall response rate was 21% (95% CI, 6%-46%) among evaluable patients. Disease control rate was 37% (95% CI, 16%-62%). Median duration of response among responders was 21.8 months (95% CI, 9.7%-not estimable). Median progression-free survival was 4.6 months (95% CI, 2.8%-7.2%). Median overall survival was 17.7 months (95% CI, 7.6%-not estimable). Grades 3-4 treatment-related adverse events occurred in 6 (23%) participants. CONCLUSIONS The combination of MEDI0457 and durvalumab demonstrated acceptable safety and tolerability in patients with advanced HPV-16/18 cancers. The low ORR among patients with cervical cancer led to study discontinuation despite a clinically meaningful disease control rate.
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Affiliation(s)
- Van K Morris
- Department of Gastrointestinal Medical Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Amir Jazaeri
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Shannon N Westin
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Curtis Pettaway
- Department of Urology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Solly George
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Ryan W Huey
- Department of Gastrointestinal Medical Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Michaela Grinsfelder
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Aaron Shafer
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Benny Johnson
- Department of Gastrointestinal Medical Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - David Vining
- Department of Radiology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Ming Guo
- Department of Pathology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Bryan Fellman
- Department of Biostatistics, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Frumovitz
- Department of Gynecologic Oncology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
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17
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Serrano Uson Junior PL, Bekaii-Saab T. Moving beyond single-agent checkpoint inhibition in biliary tract cancers: what is the next frontier? Immunotherapy 2023; 15:531-540. [PMID: 37096922 DOI: 10.2217/imt-2022-0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Background: Immunotherapy has been shown to improve outcomes for patients with cancer. Biliary tract cancers are a group of lethal diseases, and immunotherapy is an exciting new strategy to treat patients in advanced stages. Role of immunotherapy in biliary cancers: Durvalumab, an anti-PD-L1 antibody, is a new immunotherapy option for patients with advanced biliary cancers. In a randomized phase III trial, the combination of durvalumab and chemotherapy improved disease outcomes, including overall survival, in patients with advanced biliary cancers regardless of PD-L1 expression. Future perspective: Promising new combinations with new and potent antibodies or antiangiogenics are under development. Combinations with new immunotherapy agents targeting CTLA-4 or OX40 can enhance T-cell activation and improve outcomes compared with single anti-PD-1/PD-L1 agents. Furthermore, ctDNA is being used as an alternative to tissue genomic analysis and can be used to identify actionable targets. In this review, we will discuss the most important studies involving immunotherapy in biliary cancers as well as future perspectives in the field.
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18
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Zhou W, Liu H, Yuan Z, Zundell J, Towers M, Lin J, Lombardi S, Nie H, Murphy B, Yang T, Wang C, Liao L, Goldman AR, Kannan T, Kossenkov AV, Drapkin R, Montaner LJ, Claiborne DT, Zhang N, Wu S, Zhang R. Targeting the mevalonate pathway suppresses ARID1A-inactivated cancers by promoting pyroptosis. Cancer Cell 2023; 41:740-756.e10. [PMID: 36963401 PMCID: PMC10085864 DOI: 10.1016/j.ccell.2023.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/22/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
ARID1A, encoding a subunit of the SWI/SNF complex, is mutated in ∼50% of clear cell ovarian carcinoma (OCCC) cases. Here we show that inhibition of the mevalonate pathway synergizes with immune checkpoint blockade (ICB) by driving inflammasome-regulated immunomodulating pyroptosis in ARID1A-inactivated OCCCs. SWI/SNF inactivation downregulates the rate-limiting enzymes in the mevalonate pathway such as HMGCR and HMGCS1, which creates a dependence on the residual activity of the pathway in ARID1A-inactivated cells. Inhibitors of the mevalonate pathway such as simvastatin suppresses the growth of ARID1A mutant, but not wild-type, OCCCs. In addition, simvastatin synergizes with anti-PD-L1 antibody in a genetic OCCC mouse model driven by conditional Arid1a inactivation and in a humanized immunocompetent ARID1A mutant patient-derived OCCC mouse model. Our data indicate that inhibition of the mevalonate pathway simultaneously suppresses tumor cell growth and boosts antitumor immunity by promoting pyroptosis, which synergizes with ICB in suppressing ARID1A-mutated cancers.
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Affiliation(s)
- Wei Zhou
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Heng Liu
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Zhe Yuan
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Joseph Zundell
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Martina Towers
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Jianhuang Lin
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Simona Lombardi
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA; Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy
| | - Hao Nie
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Brennah Murphy
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Tyler Yang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Chen Wang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Liping Liao
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Aaron R Goldman
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Toshitha Kannan
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Andrew V Kossenkov
- Gene Expression and Regulation Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Ronny Drapkin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Obstetrics and Gynecology, Penn Ovarian Cancer Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luis J Montaner
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Daniel T Claiborne
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Nan Zhang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Shuai Wu
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Rugang Zhang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA; Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA.
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19
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van Gulijk M, Belderbos B, Dumoulin D, Cornelissen R, Bezemer K, Klaase L, Dammeijer F, Aerts J. Combination of PD-1/PD-L1 checkpoint inhibition and dendritic cell therapy in mice models and in patients with mesothelioma. Int J Cancer 2023; 152:1438-1443. [PMID: 36104949 PMCID: PMC10092125 DOI: 10.1002/ijc.34293] [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: 05/03/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 02/03/2023]
Abstract
Immunotherapy with anti-PD1/PD-L1 is effective in only a subgroup of patients with malignant pleural mesothelioma (MPM). We investigated the efficacy of a combination of anti-PD1/PD-L1 and dendritic cell (DC) therapy to optimally induce effective anti-tumor immunity in MPM in both humans and mice. Data of nine MPM patients treated with DC therapy and sequential anti-PD1 treatment were collected and analyzed for progression-free survival (PFS) and overall survival (OS). Survival and T-cell responses were monitored in AC29 mesothelioma-bearing mice treated concurrently with the combination therapy; additionally, the role of the tumor-draining lymph node (TDLN) was investigated. The combination therapy resulted in a median OS and PFS of 17.7 and 8.0 months, respectively. Grade 3 to 4 treatment-related adverse events had not been reported. Survival of the mesothelioma-bearing mice treated with the combination therapy was longer than that of untreated mice, and coincided with improved T-cell activation in peripheral blood and less T-cell exhaustion in end stage tumors. Comparable results were obtained when solely the TDLN was targeted. We concluded that this combination therapy is safe and shows promising OS and PFS. The murine data support that PD-L1 treatment may reinvigorate the T-cell responses induced by DC therapy, which may primarily be the result of TDLN targeting.
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Affiliation(s)
- Mandy van Gulijk
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bob Belderbos
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Daphne Dumoulin
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robin Cornelissen
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Koen Bezemer
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Larissa Klaase
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Floris Dammeijer
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Joachim Aerts
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
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20
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Molife C, Brnabic A, Stefaniak VJ, Belger MA, Gruver K, Chen JV, Souri S, Blumenschein GR. Sintilimab plus chemotherapy for first-line treatment of advanced or metastatic nonsquamous non-small-cell lung cancer: network meta-analysis. Immunotherapy 2023; 15:293-309. [PMID: 36748406 DOI: 10.2217/imt-2022-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: This systematic literature review and network meta-analysis evaluated the efficacy and safety of sintilimab + pemetrexed + platinum versus US FDA-approved/National Comprehensive Cancer Network-recommended immune checkpoint inhibitor (ICI) combination therapies for untreated advanced/metastatic non-squamous non-small-cell lung cancer without EGFR/ALK aberrations. Methods: Bayesian network meta-analysis was the base-case analysis and included assessment of fixed and random effects, and independent and simultaneous models, adjusting for baseline risk (placebo response). Chemotherapy was the common comparator. Results: Sintilimab + pemetrexed + platinum was associated with significantly longer progression-free survival than atezolizumab + platinum + nab-paclitaxel (hazard ratio [HR]: 0.57; 95% credible interval [CrI]: 0.40-0.82) and nivolumab + ipilimumab + pemetrexed + platinum (HR: 0.66; 95% CrI: 0.48-0.92). Sintilimab + pemetrexed + platinum and pembrolizumab + pemetrexed + platinum showed comparable progression-free survival (HR: 0.96; 95% CrI: 0.71-1.30). There was no significant difference in overall survival (HR range: 0.61-0.81) or overall response rates (odds ratio [OR] range: 0.29-0.75) between sintilimab + pemetrexed + platinum and the other ICI combinations. The incidence of high-grade adverse events was higher with sintilimab + pemetrexed + platinum than with nivolumab + ipilimumab (OR: 0.46; 95% CrI: 0.33-0.64) or without chemotherapy (OR: 0.25; 95% CrI: 0.19-0.34), with no significant difference between sintilimab + pemetrexed + platinum and the other ICI combinations. Conclusion: Sintilimab + pemetrexed + platinum showed comparable efficacy and safety versus US standard-of-care first-line ICI combinations for advanced/metastatic non-squamous non-small-cell lung cancer.
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Affiliation(s)
- Cliff Molife
- Value, Evidence, & Outcomes - Oncology, Eli Lilly & Company, Indianapolis, IN 46285, USA
| | - Alan Brnabic
- Global Statistical Sciences, Eli Lilly & Company, Sydney, NSW, Australia
| | | | - Mark A Belger
- Global Statistical Sciences, Eli Lilly & Company, Windlesham, Surry, UK
| | - Kristi Gruver
- Global Scientific Communications, Eli Lilly & Company, Indianapolis, IN 46285, USA
| | - Jing V Chen
- Medical Decision Modeling, Indianapolis, IN 46268, USA
| | - Saman Souri
- Medical Decision Modeling, Indianapolis, IN 46268, USA
| | - George R Blumenschein
- Department of Thoracic & Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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21
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Zaleskis G, Talaikis M, Characiejus D, Urbonas V, Bosas P, Darinskas A, Zibutyte L, Simkus L, Survila Z, Jursenaite J, Zvirble M. Atezolizumab Retains Cellular Binding to Programmed Death Ligand 1 Following Aerosolization via Mesh Nebulizer. Anticancer Res 2023; 43:1065-1072. [PMID: 36854531 DOI: 10.21873/anticanres.16251] [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: 12/29/2022] [Revised: 01/15/2023] [Accepted: 01/24/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND/AIM Cytotoxic inhalable drugs were shown to be advantageous in treating malignancies of the respiratory tract. However, these drugs have not always presented a safe profile and were reported to induce local adverse events. Protein-based anticancer drugs, such as immune checkpoint and vascular endothelial growth factor inhibitors, do not induce tissue injury, nor do they exhibit vesicant properties upon direct contact with tissues. Protein drugs are susceptible to the heat and stress encountered during droplet generation for delivery by nebulization. The aim of this study was to investigate the capacity of atezolizumab, an antibody to programmed death ligand 1, to bind target cells after nebulization with a vibrating mesh (VM) nebulizer. MATERIALS AND METHODS We compared Fourier-transformed infrared (FTIR) and Raman spectra of native atezolizumab (60 mg/ml) and its nebulized form following 10-min nebulization in a piezoceramic VM nebulizer. The binding of atezolizumab to DU-145 prostate cancer cells was evaluated using competitive blocking of anti-CD274 staining. RESULTS Nebulization did not induce Raman or FTIR spectral modification nor did it affect the binding capacity of atezolizumab. Conversely, heat-inactivated atezolizumab lost its cell-binding capacity and did not reduce anti-CD274 immunostaining. Native and nebulized atezolizumab displayed identical spectra, whereas the FTIR spectra of the heat-inactivated drug was significantly altered. CONCLUSION VM nebulization does not obliterate the functionality of the drug atezolizumab. The integrity of a nebulized form can be rapidly assessed by FTIR and Raman spectrometry.
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Affiliation(s)
- Gintaras Zaleskis
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania;
- Laboratory of Immunology, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Martynas Talaikis
- Center for Physical Sciences and Technology, FTMC, Vilnius University, Vilnius, Lithuania
| | - Dainius Characiejus
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Vincas Urbonas
- Laboratory of Clinical Oncology, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Paulius Bosas
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Adas Darinskas
- Laboratory of Immunology, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Lavija Zibutyte
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lukas Simkus
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Zilvinas Survila
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Jurgita Jursenaite
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Margarita Zvirble
- Laboratory of Immunology, National Cancer Institute of Lithuania, Vilnius, Lithuania
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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22
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Han Z, Wu X, Qin H, Yuan YC, Zain J, Smith DL, Akilov OE, Rosen ST, Feng M, Querfeld C. Blockade of the Immune Checkpoint CD47 by TTI-621 Potentiates the Response to Anti-PD-L1 in Cutaneous T Cell Lymphoma. J Invest Dermatol 2023:S0022-202X(23)00158-6. [PMID: 36863449 PMCID: PMC10363206 DOI: 10.1016/j.jid.2023.02.017] [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: 11/22/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
Cutaneous T cell lymphoma (CTCL) is an incurable and cosmetically disfiguring disease associated with microenvironmental signals. We investigated the effects of CD47 and PD-L1 immune checkpoint blockades, as a strategy for targeting both innate and adaptive immunity. CIBERSORT analysis identified the immune cell composition in the CTCL tumor microenvironment and the immune checkpoint expression profile for each immune cell gene cluster from CTCL lesions. We investigated the relationship between MYC and CD47 and PD-L1 expression and found that MYC shRNA knockdown and MYC functional suppression by TTI-621 (SIRPαFc) and anti-PD-L1 (durvalumab) in CTCL cell lines reduced the expression of CD47 and PD-L1 mRNA and protein as measured by qPCR and flow cytometry, respectively. In vitro, blockade of the CD47-SIRPα interaction with TTI-621 increased the phagocytic activity of macrophages against CTCL cells and enhanced CD8+ T-cell-mediated killing in a mixed leucocyte reaction. Moreover, TTI-621 synergized with anti-PD-L1 in macrophages reprogram to M1-like phenotypes and inhibited CTCL cell growth. These effects were mediated by cell‒death-related pathways, including apoptosis, autophagy, and necroptosis. Collectively, our findings demonstrate that CD47 and PD-L1 are critical regulators of immune surveillance in CTCL and dual targeting of CD47 and PD-L1 will provide insight into tumor immunotherapy for CTCL.
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Affiliation(s)
- Zhen Han
- Division of Dermatology, City of Hope, Duarte, CA; Beckman Research Institute, City of Hope, Duarte, CA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope, Duarte, CA; Computational and Quantitative Medicine, City of Hope, Duarte, CA
| | - Hanjun Qin
- Integrative Genomics Core, City of Hope, Duarte, CA
| | - Yate-Ching Yuan
- Computational and Quantitative Medicine, City of Hope, Duarte, CA; Translational Bioinformatics, Center for informatics, City of Hope, Duarte, CA
| | - Jasmine Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - D Lynne Smith
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Oleg E Akilov
- Cutaneous Lymphoma Program, Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Steven T Rosen
- Beckman Research Institute, City of Hope, Duarte, CA; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Mingye Feng
- Beckman Research Institute, City of Hope, Duarte, CA; Department of Immuno-Oncology, City of Hope, Duarte, CA
| | - Christiane Querfeld
- Division of Dermatology, City of Hope, Duarte, CA; Beckman Research Institute, City of Hope, Duarte, CA; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA; Department of Pathology, City of Hope, Duarte, CA.
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23
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Domenjo-Vila E, Casella V, Iwabuchi R, Fossum E, Pedragosa M, Castellví Q, Cebollada Rica P, Kaisho T, Terahara K, Bocharov G, Argilaguet J, Meyerhans A. XCR1+ DCs are critical for T cell-mediated immunotherapy of chronic viral infections. Cell Rep 2023; 42:112123. [PMID: 36795562 DOI: 10.1016/j.celrep.2023.112123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/29/2021] [Revised: 12/11/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
The contribution of cross-presenting XCR1+ dendritic cells (DCs) and SIRPα+ DCs in maintaining T cell function during exhaustion and immunotherapeutic interventions of chronic infections remains poorly characterized. Using the mouse model of chronic LCMV infection, we found that XCR1+ DCs are more resistant to infection and highly activated compared with SIRPα+ DCs. Exploiting XCR1+ DCs via Flt3L-mediated expansion or XCR1-targeted vaccination notably reinvigorates CD8+ T cells and improves virus control. Upon PD-L1 blockade, XCR1+ DCs are not required for the proliferative burst of progenitor exhausted CD8+ T (TPEX) cells but are indispensable to sustain the functionality of exhausted CD8+ T (TEX) cells. Combining anti-PD-L1 therapy with increased frequency of XCR1+ DCs improves functionality of TPEX and TEX subsets, while increase of SIRPα+ DCs dampened their proliferation. Together, this demonstrates that XCR1+ DCs are crucial for the success of checkpoint inhibitor-based therapies through differential activation of exhausted CD8+ T cell subsets.
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Affiliation(s)
- Eva Domenjo-Vila
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Valentina Casella
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Ryutaro Iwabuchi
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan; Department of Life Science and Medical Bioscience, Waseda University, Tokyo, Japan
| | - Even Fossum
- Department of Immunology, Division of Laboratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Mireia Pedragosa
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Quim Castellví
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Paula Cebollada Rica
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Tsuneyasu Kaisho
- Department of Immunology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazutaka Terahara
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Gennady Bocharov
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia; Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jordi Argilaguet
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain; IRTA, Centre de Recerca en Sanitat Animal (CReSA-IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Andreas Meyerhans
- Infection Biology Laboratory, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
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24
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Fischhaber N, Schmiedeberg M, Kübel S, Harrer EG, Harrer T, Nganou-Makamdop K. Ex Vivo Blockade of the PD-1 Pathway Improves Recall IFNγ Responses of HIV-Infected Persons on Antiretroviral Therapy. Vaccines (Basel) 2023; 11. [PMID: 36851089 DOI: 10.3390/vaccines11020211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/19/2023] Open
Abstract
Despite antiretroviral therapy (ART), immune exhaustion persists in HIV infection and limits T cell responses to HIV or other pathogens. Moreover, HIV infection results in the loss of pre-existing immunity. Here, we investigated the effect of blocking the PD-1 pathway on recall IFNγ responses to tetanus toxoid (TT) and measles virus (MV) antigens in HIV-infected persons on ART with prior TT and MV immunity. The ex vivo treatment of lymphocytes with anti-PD-1 and anti-PD-L1 antibodies significantly increased TT- and MV-specific IFNγ responses. The responses to TT and MV antigens alone or in combination with antibodies blocking the PD-1 pathway positively correlated with CD4 T cell levels. Furthermore, T cell PD-1 expression levels inversely correlated with recall IFNγ responses in combination with antibodies blocking the PD-1 pathway but not with IFNγ responses to antigens only. Our study suggested that targeting the PD-1 pathway may boost vaccine-induced pre-existing immunity in HIV-infected persons on ART depending on the degree of immune exhaustion.
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25
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de Carlos J, Zabalza L, Garcia J, Marti M, Ayarza-Marien X, Yoldi J. Atezolizumab induced new-onset type 1 diabetes mellitus. J Oncol Pharm Pract 2023:10781552231151656. [PMID: 36635950 DOI: 10.1177/10781552231151656] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICI) are novel therapeutic strategies in cancer treatment, promoting anti-tumor response by boosting cytotoxic T lymphocytes. Despite their high effectiveness, they can trigger the activation of diverse autoimmune diseases in genetically predisposed individuals. New-onset autoimmune diabetes mellitus type 1 (T1D) is an extremely unusual side effect, described in less than 1% of patients. CASE REPORT Here we present a 44-year-old male diagnosed with non-surgical hepatocarcinoma, developing programmed death ligand-1 inhibitor-induced autoimmune endocrinopathies, presented as diabetic ketoacidosis and thyroiditis. After two cycles of atezolizumab and bevacizumab, he consulted the emergency department with abdominal pain and diabetes cardinal features (polyuria, polydipsia, vomiting). Blood tests demonstrated hyperglycemia >800 mg/dL, capillary ketonemia >3 mmol/L, metabolic acidosis (pH 7.24 with HCO3 14 mEq/L). Subsequent studies detected a low level of C-peptide, and positive glutamic acid decarboxylase and insulinoma-associated antigen-2 antibodies. Thyroid examination was compatible with thyroiditis, showing a high free thyroxine level (1.91 ng/dL) with low thyrotropin (TSH) (0.08 mIU/L) and negative anti-TSH receptor antibody. MANAGEMENT & OUTCOME After reaching metabolic stabilization, treatment with Atezolizumab was restarted, with no further complications showing size stability in the computed tomography control. DISCUSSION T1D related to ICI is a rare condition that presents as a life-threatening emergency and should be recognized and treated early. Blood glucose and glycated hemoglobin determinations should be performed at periodic visits for detection. There are genetic factors that predispose susceptible individuals, but there is no evidence of studies to be performed before the onset of ICI or preventive strategies.
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Affiliation(s)
- Joaquín de Carlos
- Endocrinology Department, Hospital de Zumarraga, Zumarraga, Guipuzcoa, Spain
| | - Lucia Zabalza
- Gastroenterology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Javier Garcia
- Endocrinology Department, Hospital Universitario de Araba, Vitoria, Alava, Spain
| | - Miguel Marti
- Endocrinology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Xabier Ayarza-Marien
- Endocrinology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Jon Yoldi
- Endocrinology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
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26
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Leete JC, Zager MG, Musante CJ, Shtylla B, Qiao W. Sources of inter-individual variability leading to significant changes in anti-PD-1 and anti-PD-L1 efficacy identified in mouse tumor models using a QSP framework. Front Pharmacol 2022; 13:1056365. [PMID: 36545310 PMCID: PMC9760747 DOI: 10.3389/fphar.2022.1056365] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/18/2022] [Indexed: 12/08/2022] Open
Abstract
While anti-PD-1 and anti-PD-L1 [anti-PD-(L)1] monotherapies are effective treatments for many types of cancer, high variability in patient responses is observed in clinical trials. Understanding the sources of response variability can help prospectively identify potential responsive patient populations. Preclinical data may offer insights to this point and, in combination with modeling, may be predictive of sources of variability and their impact on efficacy. Herein, a quantitative systems pharmacology (QSP) model of anti-PD-(L)1 was developed to account for the known pharmacokinetic properties of anti-PD-(L)1 antibodies, their impact on CD8+ T cell activation and influx into the tumor microenvironment, and subsequent anti-tumor effects in CT26 tumor syngeneic mouse model. The QSP model was sufficient to describe the variability inherent in the anti-tumor responses post anti-PD-(L)1 treatments. Local sensitivity analysis identified tumor cell proliferation rate, PD-1 expression on CD8+ T cells, PD-L1 expression on tumor cells, and the binding affinity of PD-1:PD-L1 as strong influencers of tumor growth. It also suggested that treatment-mediated tumor growth inhibition is sensitive to T cell properties including the CD8+ T cell proliferation half-life, CD8+ T cell half-life, cytotoxic T-lymphocyte (CTL)-mediated tumor cell killing rate, and maximum rate of CD8+ T cell influx into the tumor microenvironment. Each of these parameters alone could not predict anti-PD-(L)1 treatment response but they could shift an individual mouse's treatment response when perturbed. The presented preclinical QSP modeling framework provides a path to incorporate potential sources of response variability in human translation modeling of anti-PD-(L)1.
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Affiliation(s)
- Jessica C. Leete
- Clinical Pharmacology, Early Clinical Development, Pfizer Inc., Cambridge, MA, United States,Translational Modeling and Simulation, BioMedicine Design, Pfizer Inc., Cambridge, MA, United States
| | - Michael G. Zager
- Translational Modeling and Simulation, BioMedicine Design, Pfizer Inc., La Jolla, CA, United States
| | - Cynthia J. Musante
- Quantitative Systems Pharmacology, Early Clinical Development, Pfizer Inc., Cambridge, MA, United States
| | - Blerta Shtylla
- Quantitative Systems Pharmacology, Early Clinical Development, Pfizer Inc., La Jolla, CA, United States
| | - Wenlian Qiao
- Clinical Pharmacology, Early Clinical Development, Pfizer Inc., Cambridge, MA, United States,Translational Modeling and Simulation, BioMedicine Design, Pfizer Inc., Cambridge, MA, United States,*Correspondence: Wenlian Qiao,
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27
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Simonelli M, Garralda E, Eskens F, Gil-Martin M, Yen CJ, Obermannova R, Chao Y, Lonardi S, Melichar B, Moreno V, Yu ML, Bongiovanni A, Calvo E, Rottey S, Machiels JP, Gonzalez-Martin A, Paz-Ares L, Chang CL, Mason W, Lin CC, Reardon DA, Vieito M, Santoro A, Meng R, Abbadessa G, Menas F, Lee H, Liu Q, Combeau C, Ternes N, Ziti-Ljajic S, Massard C. Isatuximab plus atezolizumab in patients with advanced solid tumors: results from a phase I/II, open-label, multicenter study. ESMO Open 2022; 7:100562. [PMID: 35987165 PMCID: PMC9588873 DOI: 10.1016/j.esmoop.2022.100562] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The anti-CD38 antibody isatuximab is approved for the treatment of relapsed/refractory multiple myeloma, but there are no data on its efficacy in solid tumors. This phase I/II study (NCT03637764) assessed the safety and activity of isatuximab plus atezolizumab (Isa + Atezo), an anti-programmed death-ligand 1 (PD-L1) antibody, in patients with immunotherapy-naive solid tumors: epithelial ovarian cancer (EOC), glioblastoma (GBM), hepatocellular carcinoma (HCC), and squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS Phase I assessed safety, tolerability, pharmacokinetics, pharmacodynamics, and the recommended phase II dose (RP2D) of isatuximab 10 mg/kg intravenously (i.v.) every week for 3 weeks followed by once every 3 weeks + atezolizumab 1200 mg i.v. every 3 weeks. Phase II used a Simon's two-stage design to assess the overall response rate or progression-free survival rate at 6 months (GBM cohort). Interim analysis was carried out at 6 months following first dose of the last enrolled patient in each cohort. Pharmacodynamic biomarkers were tested for CD38, PD-L1, tumor-infiltrating immune cells, and FOXP3+ regulatory T cells (Tregs) in the tumor microenvironment (TME). RESULTS Overall, 107 patients were treated (EOC, n = 18; GBM, n = 33; HCC, n = 27; SCCHN, n = 29). In phase I, Isa + Atezo showed an acceptable safety profile, no dose-limiting toxicities were observed, and RP2D was confirmed. Most patients experienced ≥1 treatment-emergent adverse event (TEAE), with ≤48.5% being grade ≥3. The most frequent TEAE was infusion reactions. The study did not continue to stage 2 based on prespecified targets. Tumor-infiltrating CD38+ immune cells were reduced and almost cleared after treatment. Isa + Atezo did not significantly modulate Tregs or PD-L1 expression in the TME. CONCLUSIONS Isa + Atezo had acceptable safety and tolerability. Clinical pharmacodynamic evaluation revealed efficient target engagement of isatuximab via treatment-mediated reduction of CD38+ immune cells in the TME. Based on clinical data, CD38 inhibition does not improve responsiveness to PD-L1 blockade in these patients.
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Affiliation(s)
- M Simonelli
- IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
| | - E Garralda
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - F Eskens
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Gil-Martin
- Institut Català d'Oncologia-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - C-J Yen
- National Cheng Kung University, Tainan, Taiwan
| | - R Obermannova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Y Chao
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - S Lonardi
- Veneto Institute of Oncology IOV, IRCCS, Padova, Italy
| | - B Melichar
- Department of Oncology, Palacky University, Olomouc, Czech Republic
| | - V Moreno
- START Madrid-FJD, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - M-L Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - A Bongiovanni
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - J-P Machiels
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - A Gonzalez-Martin
- Clínica Universidad de Navarra, Madrid, and Program in Solid Tumors, Center for Applied Medical Research (CIMA), Pamplona
| | - L Paz-Ares
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C-L Chang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - W Mason
- Princess Margaret Cancer Centre, Toronto, Canada
| | - C-C Lin
- National Taiwan University Hospital, Taipei, Taiwan
| | - D A Reardon
- Dana-Farber Cancer Institute, Harvard University, Boston
| | - M Vieito
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - A Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | - F Menas
- Sanofi, Chilly-Mazarin, France
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Cella E, Zullo L, Marconi S, Rossi G, Coco S, Dellepiane C, Alama A, Rozeboom L, Bennicelli E, Parisi F, Sacco G, Barletta G, Zinoli L, Tagliamento M, Pronzato P, Genova C. Immunotherapy-chemotherapy combinations for non-small cell lung cancer: current trends and future perspectives. Expert Opin Biol Ther 2022; 22:1259-1273. [PMID: 35994596 DOI: 10.1080/14712598.2022.2116273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In recent years, immunotherapy has become a pillar in the treatment of advanced, non-oncogene-addicted non-small cell lung cancer (NSCLC). Programmed death ligand 1 (PD-L1) expression is currently the only factor used to predict response to immunotherapy in clinical practice. Specifically, single agent pembrolizumab as first line therapy is approved for tumors with high expression of PD-L1 (≥50%) while immunotherapy and chemotherapy are approved for any PD-L1. However, combinations of immune-checkpoint inhibitors (ICIs) and other agents may confer higher benefit than immunotherapy alone in some circumstances. AREAS COVERED We reviewed the available data regarding the combined use of ICIs and chemotherapy in patients with advanced, treatment-naïve NSCLC. In light of the benefit demonstrated in advanced disease, these combinations have been subsequently tested in other settings. We collected the most relevant findings regarding efficacy and safety of chemo-immunotherapy combinations in early and locally advanced NSCLC. EXPERT OPINION Immune-chemotherapy combinations demonstrated benefit in the advanced setting, and this strategy in now being applied in the early and local advanced settings. A description of clinical and biological predictors of response is required in order to identify patients who may benefit the most from combination therapy.
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Affiliation(s)
- Eugenia Cella
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lodovica Zullo
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Marconi
- UO Tumori Polmonari; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Rossi
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Coco
- UO Tumori Polmonari; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Dellepiane
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Angela Alama
- UO Tumori Polmonari; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Leslie Rozeboom
- Department of Pathology, Anschutz Medical Campus, Aurora, Colorado
| | - Elisa Bennicelli
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Parisi
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Sacco
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Barletta
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Linda Zinoli
- UO Clinica di Oncologia Medica; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Tagliamento
- Dipartimento di Medicina Interna (DiMI); Università degli Studi di Genova, Genoa, Italy
| | - Paolo Pronzato
- UO Oncologia Medica 2; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Genova
- UO Clinica di Oncologia Medica; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Dipartimento di Medicina Interna (DiMI); Università degli Studi di Genova, Genoa, Italy
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Xu Y, Huang Z, Fang J, Liu A, Lu H, Yu X, Chen K, Xu X, Ma X, Shi W, Kim YH, Hakozaki T, Addeo A, Shen Y, Li S, Fan Y. Tolerability, safety, and preliminary antitumor activity of fuzuloparib in combination with SHR-1316 in patients with relapsed small cell lung cancer: a multicenter, open-label, two-stage, phase Ib trial. Transl Lung Cancer Res 2022; 11:1069-1078. [PMID: 35832454 PMCID: PMC9271434 DOI: 10.21037/tlcr-22-356] [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: 03/07/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
Background Second-line treatment options for small cell lung cancer (SCLC) are limited. Preclinical research shows that inhibition of poly (ADP-ribose) polymerase (PARP) could upregulate programmed death-ligand 1 (PD-L1), and thus render cancer cells more sensitive to immune checkpoint inhibitors. This study investigated the tolerability, safety, and preliminary antitumor activity of fuzuloparib (a PARP inhibitor) plus SHR-1316 (a PD-L1 inhibitor) for relapsed SCLC. Methods Patients with SCLC who failed previous first-line platinum-based therapy were enrolled in this two-stage phase Ib trial. In stage 1, 2 dose levels were designed: fuzuloparib 100 mg or 150 mg twice daily plus SHR-1316 600 mg every 2 weeks, with 6 patients in each dose level. Based on the tolerability during the first 28-day cycle and the preliminary antitumor activity in stage 1, a recommended phase II dose (RP2D) was determined and introduced in the stage 2 expansion phase. The primary endpoints were safety and RP2D in stage 1 and objective response rate (ORR) in stage 2. Results A total of 23 patients were enrolled, with 16 receiving fuzuloparib 100 mg plus SHR-1316 and 7 receiving fuzuloparib 150 mg plus SHR-1316. At data cutoff on April 23, 2021, the median follow-up duration was 6.4 months (IQR, 3.0–9.7 months). All patients discontinued study treatment. One patient receiving fuzuloparib 150 mg plus SHR-1316 had clinically significant toxicities, and fuzuloparib 100 mg plus SHR-1316 was considered as the RP2D. In the RP2D cohort, the confirmed ORR was 6.3% (95% CI: 0.2–30.2%), and the disease control rate was 37.5% (95% CI: 15.2–64.6%). The median progression-free survival was 1.4 months (95% CI: 1.3–2.8 months), and the median overall survival was 5.6 months (95% CI: 3.0–16.7 months). Grade ≥3 treatment-related adverse events (TRAE) occurred in 8 patients (34.8%). No treatment-related death occurred, and no patients discontinued treatment due to TRAEs. Conclusions Fuzuloparib combined with SHR-1316 failed to improve the outcomes in unselected patients with relapsed SCLC. Future studies with biomarker analysis are warranted to select patients most likely to benefit from this combination treatment. Fuzuloparib 100 and 150 mg plus SHR-1316 were both tolerable with no new signals observed.
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Affiliation(s)
- Yanjun Xu
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Zhiyu Huang
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Jian Fang
- Department of Thoracic Oncology II, Peking University Cancer Hospital, Beijing, China
| | - Anwen Liu
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hongyang Lu
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xinmin Yu
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Kaiyan Chen
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xiaoling Xu
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xinjing Ma
- Clinical Research and Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Wei Shi
- Clinical Research and Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Young Hak Kim
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taiki Hakozaki
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Alfredo Addeo
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Yu Shen
- Clinical Research and Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Shaorong Li
- Clinical Research and Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yun Fan
- Department of Medical Thoracic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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30
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Deng H, Tang F, Zhou M, Shan D, Chen X, Cao K. Identification and Validation of N6-Methyladenosine-Related Biomarkers for Bladder Cancer: Implications for Immunotherapy. Front Oncol 2022; 12:820242. [PMID: 35311150 PMCID: PMC8924666 DOI: 10.3389/fonc.2022.820242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/22/2021] [Accepted: 02/07/2022] [Indexed: 12/14/2022] Open
Abstract
N6-methyladenosine (m6A) has emerged as one of the most important modifications of RNA. Based on the expression of 23 different modes of m6A regulatory factors, we identified three different m6A modification patterns in bladder cancer. The effects of the three different modes of m6A modification on clinicopathological characteristics, immune cell infiltration levels and expression levels of immune checkpoint genes were comprehensively analyzed. In addition, the effects of different modes of m6A modification on the therapeutic efficacy of anti-PD-L1 immunotherapy (atezolizumab) are also discussed. Our results confirm that m6A methylation plays an important role in immune cell recruitment in the tumor microenvironment of bladder cancer, which influences the efficacy of anti-PD-L1 therapy for bladder cancer. We further confirmed the important role of FTO protein in the biological function of bladder cancer cells by performing in vitro experiments. FTO functions as an oncogene in bladder cancer cells, and upon FTO knockdown, the level of m6A enzyme activity in bladder cancer cells was significantly increased, apoptosis was increased, and cell proliferation and cell invasion were reduced. In addition, our study also confirmed that K216H and K216E are probably important targets for regulating FTO. We provide new insights into the regulatory pathways of the immune microenvironment and the methylation function of m6A in bladder cancer, which will help in designing novel diagnostic methods, prognostic tools, and therapeutic targets.
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Affiliation(s)
- Hongyu Deng
- Department of Clinical Laboratory, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, China
| | - Faqing Tang
- Department of Clinical Laboratory, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,NHC Key Laboratory of Carcinogenesis, Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ming Zhou
- Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, China.,NHC Key Laboratory of Carcinogenesis, Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Dongyong Shan
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xingyu Chen
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ke Cao
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, China
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Solomon B, Callejo A, Bar J, Berchem G, Bazhenova L, Saintigny P, Wunder F, Raynaud J, Girard N, Lee JJ, Sulaiman R, Prouse B, Bresson C, Ventura H, Magidi S, Rubin E, Young B, Onn A, Leyland-Jones B, Schilsky RL, Lazar V, Felip E, Kurzrock R. A WIN Consortium phase I study exploring avelumab, palbociclib, and axitinib in advanced non-small cell lung cancer. Cancer Med 2022; 11:2790-2800. [PMID: 35307972 PMCID: PMC9302335 DOI: 10.1002/cam4.4635] [Citation(s) in RCA: 2] [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: 09/29/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 01/15/2023] Open
Abstract
Background The Worldwide Innovative Network (WIN) Consortium has developed the Simplified Interventional Mapping System (SIMS) to better define the cancer molecular milieu based on genomics/transcriptomics from tumor and analogous normal tissue biopsies. SPRING is the first trial to assess a SIMS‐based tri‐therapy regimen in advanced non‐small cell lung cancer (NSCLC). Methods Patients with advanced NSCLC (no EGFR, ALK, or ROS1 alterations; PD‐L1 unrestricted; ≤2 prior therapy lines) received avelumab, axitinib, and palbociclib (3 + 3 dose escalation design). Results Fifteen patients were treated (five centers, four countries): six at each of dose levels 1 (DL1) and DL2; three at DL3. The most common ≥Grade 3 adverse events were neutropenia, hypertension, and fatigue. The recommended Phase II dose (RP2D) was DL1: avelumab 10 mg/kg IV q2weeks, axitinib 3 mg po bid, and palbociclib 75 mg po daily (7 days off/21 days on). Four patients (27%) achieved a partial response (PR) (progression‐free survival [PFS]: 14, 24, 25 and 144+ weeks), including two after progression on pembrolizumab. Four patients attained stable disease (SD) that lasted ≥24 weeks: 24, 27, 29, and 64 weeks. At DL1 (RP2D), four of six patients (66%) achieved stable disease (SD) ≥6 months/PR (2 each). Responders included patients with no detectable PD‐L1 expression and low tumor mutational burden. Conclusions Overall, eight of 15 patients (53%) achieved clinical benefit (SD ≥ 24 weeks/PR) on the avelumab, axitinib, and palbociclib combination. This triplet showed antitumor activity in NSCLC, including in tumors post‐pembrolizumab progression, and was active at the RP2D, which was well tolerated. NCT03386929 clinicaltrial.gov
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Affiliation(s)
| | - Ana Callejo
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - Jair Bar
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Guy Berchem
- Centre Hospitalier de Luxembourg, Luxembourg Institute of Health, Luxembourg City, Luxemburg
| | - Lyudmila Bazhenova
- University of California San Diego, Moores Cancer Center, San Diego, California, USA
| | - Pierre Saintigny
- Centre Léon Bérard, Cancer Research Center of Lyon, University of Lyon, Lyon, France
| | - Fanny Wunder
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | | | | | - J Jack Lee
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Raed Sulaiman
- Avera Cancer Institute, Sioux Falls, South Dakota, USA
| | - Bruce Prouse
- Avera Cancer Institute, Sioux Falls, South Dakota, USA
| | - Catherine Bresson
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | - Hila Ventura
- Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Shai Magidi
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | - Eitan Rubin
- Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Amir Onn
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Brian Leyland-Jones
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | - Richard L Schilsky
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | - Vladimir Lazar
- Worldwide Innovative Network (WIN) Association - WIN Consortium, Villejuif, France
| | - Enriqueta Felip
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - Razelle Kurzrock
- University of California San Diego, Moores Cancer Center, San Diego, California, USA
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Chaurasiya S, Yang A, Zhang Z, Lu J, Valencia H, Kim SI, Woo Y, Warner SG, Olafsen T, Zhao Y, Wu X, Fein S, Cheng L, Cheng M, Ede N, Fong Y. A comprehensive preclinical study supporting clinical trial of oncolytic chimeric poxvirus CF33-hNIS- anti-PD-L1 to treat breast cancer. Mol Ther Methods Clin Dev 2022; 24:102-116. [PMID: 35024377 PMCID: PMC8718831 DOI: 10.1016/j.omtm.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/16/2021] [Accepted: 12/04/2021] [Indexed: 01/12/2023]
Abstract
CF33-hNIS-anti-PD-L1 is an oncolytic chimeric poxvirus encoding two transgenes: human sodium iodide symporter and a single-chain variable fragment against PD-L1. Comprehensive preclinical pharmacology studies encompassing primary and secondary pharmacodynamics and biodistribution and safety studies were performed to support the clinical development of CF33-hNIS-anti-PD-L1. Most of the studies were performed in triple-negative breast cancer (TNBC) models, as the phase I trial is planned for patients with TNBC. Biological functions of virus-encoded transgenes were confirmed, and the virus demonstrated anti-tumor efficacy against TNBC models in mice. In a good laboratory practice (GLP) toxicology study, the virus did not produce any observable adverse effects in mice, suggesting that the doses proposed for the clinical trial should be well tolerated in patients. Furthermore, no neurotoxic effects in mice were seen following intracranial injection of the virus. Also, the risk for horizontal transmission of CF33-hNIS-anti-PD-L1 was assessed in mice, and our results suggest that the virus is unlikely to transmit from infected patients to healthy individuals. Finally, the in-use stability and compatibility of CF33-hNIS-anti-PD-L1 tested under different conditions mimicking the clinical scenarios confirmed the suitability of the virus in clinical settings. The results of these preclinical studies support the use of CF33-hNIS-anti-PD-L1 in a first-in-human trial in patients with TNBC.
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Affiliation(s)
- Shyambabu Chaurasiya
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Annie Yang
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Zhifang Zhang
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Jianming Lu
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Hannah Valencia
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Sang-In Kim
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Yanghee Woo
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
| | - Suanne G Warner
- Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Tove Olafsen
- Small Animal Imaging Core, Shared Resources, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Yuqi Zhao
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA 91010, USA
| | | | | | | | | | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Familian Science building, Room#1100 1500 E Duarte Road, Duarte, CA 91010, USA
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Jiang Y, Wen W, Yang F, Han D, Zhang W, Qin W. Prospect of Prostate Cancer Treatment: Armed CAR-T or Combination Therapy. Cancers (Basel) 2022; 14:cancers14040967. [PMID: 35205714 PMCID: PMC8869943 DOI: 10.3390/cancers14040967] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/13/2021] [Revised: 01/29/2022] [Accepted: 02/12/2022] [Indexed: 02/06/2023] Open
Abstract
The incidence rate of prostate cancer is higher in male cancers. With a hidden initiation of disease and long duration, prostate cancer seriously affects men's physical and mental health. Prostate cancer is initially androgen-dependent, and endocrine therapy can achieve good results. However, after 18-24 months of endocrine therapy, most patients eventually develop castration-resistant prostate cancer (CRPC), which becomes metastatic castration resistant prostate cancer (mCRPC) that is difficult to treat. Chimeric Antigen Receptor T cell (CAR-T) therapy is an emerging immune cell therapy that brings hope to cancer patients. CAR-T has shown considerable advantages in the treatment of hematologic tumors. However, there are still obstacles to CAR-T treatment of solid tumors because the physical barrier and the tumor microenvironment inhibit the function of CAR-T cells. In this article, we review the progress of CAR-T therapy in the treatment of prostate cancer and discuss the prospects and challenges of armed CAR-T and combined treatment strategies. At present, there are still many obstacles in the treatment of prostate cancer with CAR-T, but when these obstacles are solved, CAR-T cells can become a favorable weapon for the treatment of prostate cancer.
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Affiliation(s)
- Yao Jiang
- Department of Urology, First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China; (Y.J.); (F.Y.); (D.H.)
| | - Weihong Wen
- Department of Medical Research, Northwestern Polytechnical University, Xi’an 710072, China
- Correspondence: (W.W.); (W.Q.)
| | - Fa Yang
- Department of Urology, First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China; (Y.J.); (F.Y.); (D.H.)
| | - Donghui Han
- Department of Urology, First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China; (Y.J.); (F.Y.); (D.H.)
| | - Wuhe Zhang
- Department of Urology, Air Force 986 Hospital, Xi’an 710054, China;
| | - Weijun Qin
- Department of Urology, First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China; (Y.J.); (F.Y.); (D.H.)
- Correspondence: (W.W.); (W.Q.)
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Bhardwaj M, Chiu MN, Pilkhwal Sah S. Adverse cutaneous toxicities by PD-1/PD-L1 immune checkpoint inhibitors: Pathogenesis, Treatment, and Surveillance. Cutan Ocul Toxicol 2022; 41:73-90. [PMID: 35107396 DOI: 10.1080/15569527.2022.2034842] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Introduction-The therapeutic use of humanized monoclonal programmed cell death 1 (PD-1) (pembrolizumab, and nivolumab) and programmed cell death ligand-1 (PD-L1) (atezolizumab, avelumab, durvalumab) immune checkpoint inhibitors (ICPi) as potent anticancer therapies is rapidly increasing. The mechanism of signaling of anti-PD-1/PD-L1 involves triggering cytotoxic CD4+/CD8 + T cell activation and subsequent abolition of cancer cells which induces specific immunologic adverse events that are specific to these therapies. These drugs can cause numerous cutaneous reactions and are characterized as the most frequent immune-related adverse events (irAEs). Majority of cutaneous irAEs range from nonspecific eruptions to detectible skin manifestations, which may be self-limiting and present acceptable skin toxicity profiles, while some may produce life-threatening complications.Objective-.This review aims to illuminate the associated cutaneous irAEs related to drugs used in oncology along with the relevant mechanism(s) and management.Areas covered-Literature was searched using various databases including Pub-Med, Google Scholar, and Medline. The search mainly involved research articles, retrospective studies, case reports, and clinicopathological findings. With this review article, an overview of the cutaneous irAEs with anti-PD-1/PD-L1 therapy, as well as suggestions, have been provided, so that their recognition at early stages could help in better management and would prevent treatment discontinuation.Article highlightsCutaneous adverse effects are the most prevalent immune-related adverse events induced by anti-PD-1/PD-L1 immune-checkpoint antibodies.Cutaneous toxicities mainly manifest in the form of maculopapular rash and pruritus.More specific cutaneous complications can also occur, including vitiligo, worsened psoriasis, lichenoid dermatitis, mucosal involvement (e.g., oral lichenoid reaction), dermatomyositis, lupus erythematosus.Cutaneous manifestations can be life-threatening including Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN).Dermatologic toxicities are usually mild, readily manageable, and rarely result in significant morbidity.Adequate management of the cutaneous adverse event and recognition in early stages could lead to the prevention of worsening of the lesions and limit treatment disruption.
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Affiliation(s)
- Maitry Bhardwaj
- Faculty of Pharmaceutical Sciences, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, 160014, India
| | - Mei Nee Chiu
- Faculty of Pharmaceutical Sciences, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, 160014, India
| | - Sangeeta Pilkhwal Sah
- Faculty of Pharmaceutical Sciences, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, 160014, India
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Muniz TP, Araujo DV, Savage KJ, Cheng T, Saha M, Song X, Gill S, Monzon JG, Grenier D, Genta S, Allen MJ, Arteaga DP, Saibil SD, Butler MO, Spreafico A, Hogg D. CANDIED: A Pan-Canadian Cohort of Immune Checkpoint Inhibitor-Induced Insulin-Dependent Diabetes Mellitus. Cancers (Basel) 2021; 14:cancers14010089. [PMID: 35008256 PMCID: PMC8750429 DOI: 10.3390/cancers14010089] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Immune checkpoint inhibitor-induced insulin-dependent diabetes mellitus (ICI-induced IDDM) is an emerging form of autoimmune diabetes. We describe the characteristics of 34 patients who developed ICI-induced IDDM across five Canadian cancer centres. We observed that presentation with hyperglycemic crisis is common and that patients treated with combination immunotherapy regimens develop ICI-induced IDDM earlier than those treated with monotherapy. Our results suggest that ICI-induced IDDM is irreversible but is associated with high tumor response rates and prolonged survival. The data generated by this study may help clinicians manage ICI-induced IDDM. Abstract Immune checkpoint inhibitor (ICI)-induced insulin-dependent diabetes mellitus (IDDM) is a rare but potentially fatal immune-related adverse event (irAE). In this multicentre retrospective cohort study, we describe the characteristics of ICI-induced IDDM in patients treated across five Canadian cancer centres, as well as their tumor response rates and survival. In 34 patients identified, 25 (74%) were male and 19 (56%) had melanoma. All patients received anti-programed death 1 (anti-PD1) or anti-programmed death ligand-1 (anti-PD-L1)-based therapy. From ICI initiation, median time to onset of IDDM was 2.4 months (95% CI 1.1–3.6). Patients treated with anti-PD1/PD-L1 in combination with an anti-cytotoxic T lymphocyte antigen 4 antibody developed IDDM earlier compared with patients on monotherapy (1.4 vs. 3.9 months, p = 0.05). Diabetic ketoacidosis occurred in 21 (62%) patients. Amongst 30 patients evaluable for response, 10 (33%) had a complete response and another 10 (33%) had a partial response. Median overall survival was not reached (95% CI NE; median follow-up 31.7 months). All patients remained insulin-dependent at the end of follow-up. We observed that ICI-induced IDDM is an irreversible irAE and may be associated with a high response rate and prolonged survival.
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Affiliation(s)
- Thiago P. Muniz
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
- Correspondence:
| | - Daniel V. Araujo
- Hospital de Base, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto 15090-000, Brazil;
| | - Kerry J. Savage
- Division of Medical Oncology, Department of Medicine, The University of British Columbia, Vancouver, BC V5Z 1M9, Canada;
| | - Tina Cheng
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (T.C.); (J.G.M.)
| | - Moumita Saha
- Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada; (M.S.); (S.G.)
| | - Xinni Song
- The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON K1H 8L6, Canada;
| | - Sabrina Gill
- Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada; (M.S.); (S.G.)
| | - Jose G. Monzon
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (T.C.); (J.G.M.)
| | - Debjani Grenier
- Department of Medical Oncology, University of Manitoba, Winnipeg, MB R3A 1R9, Canada;
| | - Sofia Genta
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - Michael J. Allen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - Diana P. Arteaga
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - Samuel D. Saibil
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - Marcus O. Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
| | - David Hogg
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada; (S.G.); (M.J.A.); (D.P.A.); (S.D.S.); (M.O.B.); (A.S.); (D.H.)
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Latif F, Bint Abdul Jabbar H, Malik H, Sadaf H, Sarfraz A, Sarfraz Z, Cherrez-Ojeda I. Atezolizumab and pembrolizumab in triple-negative breast cancer: a meta-analysis. Expert Rev Anticancer Ther 2021; 22:229-235. [PMID: 34949142 DOI: 10.1080/14737140.2022.2023011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The approval of anti-PD-L1 drugs, including atezolizumab/pembrolizumab in triple-negative breast cancer (TNBC), offer potential improvement to current treatment regimens available for TNBC. METHODS We conducted a meta-analysis to review the efficacy of Atezolizumab/Pembrolizumab for the treatment of TNBC in both the adjuvant and neoadjuvant settings. We calculated standardized mean difference (SMD) for the associations of progression-free survival (PFS) and overall survival (OS) and odds ratios (ORs) to estimate the association between objective response rate (ORR) and pathological complete response (pCR), using 95% confidence intervals (CIs). RESULTS Six clinical trials comprising 3612 patients were identified. For adjuvant therapies, the ORR (OR=1.26, P=0.04) of atezolizumab/pembrolizumab plus chemotherapy was higher in the intention to treat (ITT) arms than the placebo groups in TNBC. The positive effect size was found for PFS in the ITT arms (Cohen's d=1.55, P<0.001). The atezolizumab plus chemotherapy group had a positive effect size for OS compared to the control groups (Cohen's d=0.52, P<0.001). In the neoadjuvant setting, patients in ITT arms had higher pCR rates than the control groups (OR=1.61, P=0.001). CONCLUSION We collate evidence of atezolizumab/pembrolizumab as viable therapeutics among patients with TNBC with PD-L1 subgroups deriving higher benefits.
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Affiliation(s)
- Farah Latif
- Fatima Jinnah Medical University, Lahore, Pakistan
| | | | - Hamna Malik
- Services Institute of Medical Sciences, Lahore, Pakistan
| | - Humaira Sadaf
- University of Texas Health Science Centers, McGovern Medical School, Houston, Texas, USA
| | - Azza Sarfraz
- The Aga Khan University, Karachi, Sindh, Pakistan
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JiaWei Z, ChunXia D, CunDong L, Yang L, JianKun Y, HaiFeng D, Cheng Y, ZhiPeng H, HongYi W, DeYing L, ZhiJian L, Xiao X, QiZhao Z, KangYi X, WenBing G, Ming X, JunHao Z, JiMing B, ShanChao Z, MingKun C. M2 subtype tumor associated macrophages (M2-TAMs) infiltration predicts poor response rate of immune checkpoint inhibitors treatment for prostate cancer. Ann Med 2021; 53:730-740. [PMID: 34032524 PMCID: PMC8158194 DOI: 10.1080/07853890.2021.1924396] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) is poor response to the immunotherapy for its high heterogeneity of immune microenvironment. In this study, we aim to introduce a new immune subtype for PCa involving M2 tumour associated macrophages (M2-TAMs). METHODS Three hundred and sixty-two PCa patients and matched normal prostate tissues were selected from the Cancer Genome Atlas and Gene Expression Omnibus databases. Patients' immune infiltration characters were then analyzed based on the gene expressions. The immune subtypes were identified by the method of unsupervised hierarchical clustering. Finally, the relationship between the M2-TAMs infiltration and anti-programmed death-ligand-1 (PD-L1) therapy was investigated in the IMvigor210 cohort. RESULTS PCa expressed lower immune-related genes levels compared with the adjacent normal tissues. Based on the proved immunosuppressive mechanisms in PCa, tumour patients were classified into three independent subclasses with high infiltrated cytolytic activity (CYT), M2-TAMs and regulatory T cell (Tregs), respectively. Among these subtypes, M2-TAMs infiltration subtype showed the worst clinicopathological features and prognosis compared with the other two subtypes. The results of the IMvigor210 cohort demonstrated poor response of anti-PD-L1 therapy for patients with high M2-TAMs infiltration. CONCLUSION Prostate tumours involved in significant immunosuppression, and high infiltration of M2-TAMs can be applied to predict the effect of anti-PD-L1 therapy.Key MessagesPCa patients can be classified into three immunotypes of high infiltrated CYT, M2-TAMS, and Tregs according to the immunosuppressive mechanisms.High M2-TAMs infiltration subtype reflected the worst clinical characters, immune infiltration, and lowest expression of immune checkpoint inhibitors among the three subclasses in PCa.High M2-TAMs infiltration predicts the low response rate of anti-PD-L1 therapy.
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Affiliation(s)
- Zhou JiaWei
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Dou ChunXia
- College of Nursing, Jinan University, Guangzhou, China
| | - Liu CunDong
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Liu Yang
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yang JianKun
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Duan HaiFeng
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yang Cheng
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Huang ZhiPeng
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Wang HongYi
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Liao DeYing
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Liang ZhiJian
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xie Xiao
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Zhou QiZhao
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xue KangYi
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Guo WenBing
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xia Ming
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Zhou JunHao
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Bao JiMing
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Zhao ShanChao
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- Department of Urology, Nangfang Hospital, Southern Medical University, Guangzhou, China
| | - Chen MingKun
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- Department of Urology, Nangfang Hospital, Southern Medical University, Guangzhou, China
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Filippi AR, Dziadziuszko R, García Campelo MR, Paoli JB, Sawyer W, Díaz Pérez IE. DUART: durvalumab after radiotherapy in patients with unresectable, stage III NSCLC who are ineligible for chemotherapy. Future Oncol 2021; 17:4657-4663. [PMID: 34775804 DOI: 10.2217/fon-2021-0952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Consolidation durvalumab is standard of care in patients with unresectable, stage III non-small-cell lung cancer (NSCLC) without disease progression following chemoradiotherapy (the 'PACIFIC regimen'). However, many patients with poor performance status, older age or comorbidities may be ineligible for chemotherapy due to expected high toxicity. These patients typically receive radiotherapy alone, with poor survival outcomes. Based on the PACIFIC trial data, and the strong biological rationale for combining radiotherapy with anti-programmed cell death ligand-1 therapy, durvalumab following radiotherapy could provide additional survival benefit versus radiotherapy alone. Here, we describe the DUART trial, a Phase II, open-label, single-arm study assessing the safety and tolerability of durvalumab following radiotherapy in patients with unresectable, stage III NSCLC who are ineligible for chemotherapy (ClinicalTrials.gov Identifier: NCT04249362).
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Affiliation(s)
- Andrea R Filippi
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo & University of Pavia, Pavia 27100, Italy
| | - Rafał Dziadziuszko
- Department of Oncology & Radiotherapy, Medical University of Gdansk, Gdansk 80-210, Poland
| | | | | | - William Sawyer
- Global Medicines Development, AstraZeneca, Cambridge, CB2 0AA, UK
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Zhang Y, Wang T, Zhuang Y, He T, Wu X, Su L, Kang J, Chang J, Wang H. Sodium Alginate Hydrogel-Mediated Cancer Immunotherapy for Postoperative In Situ Recurrence and Metastasis. ACS Biomater Sci Eng 2021; 7:5717-5726. [PMID: 34757733 DOI: 10.1021/acsbiomaterials.1c01216] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
With the development of technology, adjuvant immunotherapy has become a promising strategy for prevention of postoperative tumor regression and metastasis by stimulating the host immune response. However, the therapeutic effects are still unsatisfactory due to the lack of synergy between different methods. In this study, an efficient synergistic immunotherapy system based on injectable sodium alginate hydrogels was designed to inhibit in situ recurrence and metastasis at the same time. On the one hand, an injectable sodium alginate (SA) hydrogel microsystem loaded with toll-like receptor (TLR) agonists (CpG ODNs) was synthesized for inhibiting in situ recurrence, and then carcinoembryonic antigen (CEA) probe was also added to detect CEA based on fluorescence resonance energy transfer (FRET) technology to monitor the occurrence and development of tumor recurrence. On the other hand, an anti-programmed cell death 1 ligand 1 antibody (anti-PD-L1)-modified SA nanogel loaded with indocyanine green (ICG@SA-anti-PD-L1 nanogel) was prepared for diagnosing and inhibiting lung metastasis by assisting orthotopic tumor therapy. In vitro and in vivo results demonstrated that this SA micro/nanosystem could monitor and inhibit postoperative recurrence and metastasis. We hope that this micro/nano-synergistic system will become an effective strategy for postoperative adjuvant immunotherapy.
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Affiliation(s)
- Yingying Zhang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China.,School of Medical Imaging, Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
| | - Tiange Wang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
| | - Yinping Zhuang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
| | - Tiandi He
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
| | - Xiaoli Wu
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
| | - Lin Su
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin 300384, China
| | - Jun Kang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
| | - Jin Chang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
| | - Hanjie Wang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin University, Tianjin 300072, China
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Abdihamid O, Omar A, Rugambwa T. Defining the correlation between immune-checkpoint inhibitors-related adverse events and clinical outcomes: a narrative review. Ecancermedicalscience 2021; 15:1314. [PMID: 35047065 PMCID: PMC8723746 DOI: 10.3332/ecancer.2021.1314] [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: 03/07/2021] [Indexed: 11/21/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have increased modern anticancer armamentarium portfolios, with 15%-60% of cancer patients deriving clinical benefit while others progress, including some occurrences of accelerated progressions. ICIs have also introduced a new pattern of immune-related adverse events (irAEs). Recently, a mechanistic link was proposed in which patients who develop ICIs-related irAEs derive a survival benefit compared to those who do not, suggesting an overlap between toxicities and the treatment efficacy. Identifying predictive biomarkers to optimally identify patients who will benefit from ICIs is a contemporary research area in Oncology. However, the data remains sparse, with only several smaller studies showing a plausible direct proportionality of a therapeutic effect across tumours. In contrast, the overall survival and progression-free survival rate depend on the tumour type, degree of toxicities, duration of exposure, affected system/organs and inherent patient characteristics. Furthermore, the occurrence of irAEs appears to be more associated with a clinical benefit from programmed death 1 and programmed death-ligand 1 inhibitors than anti-cytotoxic T-lymphocyte-associated antigen 4. Several questions remain unanswered, including the association between survival benefit and specific type of organ system toxicities, toxicity grade, if the benefit is entirely due to immortal-time biases (ITBs), presence of patients confounding comorbidities like autoimmune diseases, and finally, immune heterogeneities. Considering ITB represents a key element in interpreting these studies since patients with precipitated death or with an earlier disease progresses rarely develop irAEs; in fact, such patients have not stayed in the study long enough to experience such irAEs. Conversely, patients that stayed in the study for a longer period have a higher risk of developing irAEs. Landmark analysis is key in these studies if a real association is to be found. Overall response and disease control rates are mainly higher in those who develop irAEs due to immune activation. So, this review aims to summarise the evidence from key studies that addressed this important clinical question.
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Affiliation(s)
- Omar Abdihamid
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People’s Republic of China
| | - Abeid Omar
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Alexandria University, Champlion Street, Alazarita, Alexandria 21131, Egypt
| | - Tibera Rugambwa
- Department of Internal Medicine, Mbeya Zonal Referral Hospital, Mbeya 419, Tanzania
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Rodríguez Plá M, Dualde Beltrán D, Ferrer Albiach E. Immune Checkpoints Inhibitors and SRS/SBRT Synergy in Metastatic Non-Small-Cell Lung Cancer and Melanoma: A Systematic Review. Int J Mol Sci 2021; 22:ijms222111621. [PMID: 34769050 PMCID: PMC8584181 DOI: 10.3390/ijms222111621] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Several immunotherapy (IT) agents are FDA approved for treatment of melanoma and non-small-cell lung cancer (NSCLC). The addition of stereotactic radiosurgery (SRS) or stereotactic body radiation therapy (SBRT) to immunotherapy looks promising. A systematic review was conducted to evaluate the possible synergistic effects of immune checkpoints inhibitors (ICIs) and stereotactic radiation therapy in melanoma and NSCLC. Materials and methods: Pubmed databases from January 2010 to December 2020 were reviewed to identify English language studies reporting control of local and abscopal effect of the combination of ICI-SBRT/SRS in metastatic NSCLC and melanoma cancer. The inclusion criteria were followed according to PICO criteria. Results: Thirty-nine articles were included of the 2141 initial results. The reported rates for local control were 16.5–100% and 40–94% in brain and extracerebral metastases, respectively. Distant/abscopal response rates were 1–45% in extracerebral metastases. Abscopal effect could not be evaluated in brain metastases because it was not reported in studies. Treatments were well tolerated with few grade 4 toxicities and no grade 5. Conclusions: The combined treatment of ICI-SBRT/SRS achieves high local control and non-negligible abscopal response in patients with extracerebral metastases, with its benefit in cerebral metastases being more controversial. Clinical trials are needed to better characterize the potential synergism.
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Song G, Lu Y, Tang L, Li M, Yin J, Chen H, Ling J. (-)-4- O-(4- O- β- D-glucopyranosylcaffeoyl) quinic acid enhanced the efficacy of anti-PD-L1 against esophageal carcinoma through inhibiting PI3K pathway. Immunopharmacol Immunotoxicol 2021; 43:806-812. [PMID: 34694960 DOI: 10.1080/08923973.2021.1990315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Using antibodies to block the programmed cell death 1 (PD-1)/programmed cell death-ligand 1 (PD-L1) pathway as an immunotherapy has achieved great success in the clinical treatment of various types of carcinoma. However, the efficacy is limited because of tumor-mediated immune immunosuppression and evasion. This study demonstrated that inhibiting the PI3K pathway with (-)-4-O-(4-O-β-D-glucopyranosylcaffeoyl) quinic acid (QA), a new compound from endophytic fungus Penicillium citrinum of Avicennia marina, enhanced the therapeutic efficacy of anti-PD-L1 antibody against esophageal tumors. MATERIALS AND METHODS mEC25 cells were injected into C57BL/6 mice to establish a syngeneic esophageal tumor model. Tumor infiltration lymphocytes (TILs) were analyzed by flow cytometry. Gene and protein expression was detected by qPCR and western blot, respectively. Moreover, the therapeutic effects of QA combining with anti-PD-L1 antibody were evaluated in the tumor model. RESULTS These data demonstrated that inhibition of PI3K with QA could overcome immunosuppression and promote the response of T-lymphocytes, resulting in the restoration of cytotoxic T cell-mediated tumor control. QA and anti-PD-L1 combination therapy significantly delayed tumor growth. CONCLUSIONS Our results provide a scientific basis to develop combination therapies involving anti-PD-L1 and PI3K inhibitors to improve responses in patients with esophageal cancer.
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Affiliation(s)
- GuangLin Song
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - YanLing Lu
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - LiNa Tang
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - Min Li
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - Jie Yin
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - HongMing Chen
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
| | - JunDa Ling
- Department of Oncology, People's Hospital of Yuechi County, Yuechi, P.R. China
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Deligiorgi MV, Sagredou S, Vakkas L, Trafalis DT. The Continuum of Thyroid Disorders Related to Immune Checkpoint Inhibitors: Still Many Pending Queries. Cancers (Basel) 2021; 13:5277. [PMID: 34771441 PMCID: PMC8582503 DOI: 10.3390/cancers13215277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Until more data are available to shed light on the thyroid disorders related to immune checkpoint inhibitors (ICPi) implemented for the treatment of hematological malignancies, the decision-making is guided by pertinent data derived mostly from solid tumors. METHODS The present review provides a comprehensive and updated overview of the thyroid disorders related to ICPi, namely to inhibitors of cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death (PD) 1 (PD-1), and the ligand of the latter (PD-L1). RESULTS With the increasing recognition of ir thyroid disorders, many outstanding issues have emerged. Ir thyroid disorders are reminiscent of, but not identical to, thyroid autoimmunity. Interclass and intraclass ICPi differences regarding thyroid immunotoxicity await interpretation. The available data concerning the predictive value of thyroid autoantibodies for the development of ir thyroid disorders are inconclusive. Mounting data indicate an association of ir thyroid disorders with ICPi efficacy, but a causative link is still lacking. The path forward is a tailored approach, entailing: (i) the validation of tumor-specific, patient-specific, and ICPi-specific predictive factors; (ii) appropriate patient selection; (iii) the uncoupling of antitumor immunity from immunotoxicity; (iv) a multidisciplinary initiative; and (v) global registry strategies. CONCLUSIONS Untangling and harnessing the interrelationship of immuno-oncology with endocrinology underlying the ir thyroid disorders will yield the optimal patient care.
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Affiliation(s)
- Maria V. Deligiorgi
- Department of Pharmacology—Clinical Pharmacology Unit, Faculty of Medicine, National and Kapodistrian University of Athens, Building 16, 1st Floor, 75 Mikras Asias Str., Goudi, 11527 Athens, Greece; (S.S.); (L.V.); (D.T.T.)
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Yuan Z, Fan G, Wu H, Liu C, Zhan Y, Qiu Y, Shou C, Gao F, Zhang J, Yin P, Xu K. Photodynamic therapy synergizes with PD-L1 checkpoint blockade for immunotherapy of CRC by multifunctional nanoparticles. Mol Ther 2021; 29:2931-2948. [PMID: 34023507 PMCID: PMC8530932 DOI: 10.1016/j.ymthe.2021.05.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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] [Received: 09/21/2020] [Revised: 02/14/2021] [Accepted: 05/18/2021] [Indexed: 12/30/2022] Open
Abstract
Checkpoint inhibitors, such as anti-PD-1/PD-L1 antibodies, have been shown to be extraordinarily effective, but their durable response rate remains low, especially in colorectal cancer (CRC). Recent studies have shown that photodynamic therapy (PDT) could effectively enhance PD-L1 blockade therapeutic effects, although the reason is still unclear. Here, we report the use of multifunctional nanoparticles (NPs) loaded with photosensitized mTHPC (mTHPC@VeC/T-RGD NPs)-mediated PDT treatment to potentiate the anti-tumor efficacy of PD-L1 blockade for CRC treatment and investigate the underlying mechanisms of PDT enhancing PD-L1 blockade therapeutic effect in this combination therapy. In this study, the mTHPC@VeC/T-RGD NPs under the 660-nm near infrared (NIR) laser could kill tumor cells by inducing apoptosis and/or necrosis and stimulating systemic immune response, which could be further promoted by the PD-L1 blockade to inhibit primary and distant tumor growth, as well as building long-term host immunological memory to prevent tumor recurrence. Furthermore, we detected that mTHPC@VeC/T-RGD NP-mediated PDT sensitizes tumors to PD-L1 blockade therapy mainly because PDT-mediated hypoxia could induce the hypoxia-inducible factor 1α (HIF-1α) signaling pathway that upregulates PD-L1 expression in CRC. Taken together, our work demonstrates that mTHPC@VeC/T-RGD NP-mediated PDT is a promising strategy that may potentiate the response rate of anti-PD-L1 checkpoint blockade immunotherapies in CRC.
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Affiliation(s)
- Zeting Yuan
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Department of Pharmaceutics, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China; Shanghai Putuo Central School of Clinical Medicine, Anhui Medical University, Hefei 230032, China
| | - Guohua Fan
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
| | - Honglei Wu
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Department of General Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
| | - Chaolian Liu
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Department of Pharmaceutics, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Yueping Zhan
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
| | - Yanyan Qiu
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
| | - Chenting Shou
- Department of Pharmaceutics, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Feng Gao
- Department of Pharmaceutics, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Jun Zhang
- Division of Medical Oncology, Department of Internal Medicine, Department of Cancer Biology, University of Kansas Cancer Center, University of Kansas Medical Center, 3005 Wahl Hall East, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Peihao Yin
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Shanghai Putuo Central School of Clinical Medicine, Anhui Medical University, Hefei 230032, China; Department of General Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China.
| | - Ke Xu
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China; Interventional Cancer Institute of Chinese Integrative Medicinel, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Shanghai Putuo Central School of Clinical Medicine, Anhui Medical University, Hefei 230032, China; Wenzhou Institute of Shanghai University, Wenzhou 325000, China.
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Jain P, Gutierrez Bugarin J, Guha A, Jain C, Patil N, Shen T, Stanevich I, Nikore V, Margolin K, Ernstoff M, Velcheti V, Barnholtz-Sloan J, Dowlati A. Cardiovascular adverse events are associated with usage of immune checkpoint inhibitors in real-world clinical data across the United States. ESMO Open 2021; 6:100252. [PMID: 34461483 PMCID: PMC8403739 DOI: 10.1016/j.esmoop.2021.100252] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 04/08/2021] [Revised: 06/23/2021] [Accepted: 08/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Immune checkpoint inhibitors (ICIs) can cause life-threatening cardiovascular adverse events (CVAEs) that may not be attributed to therapy. The outcomes of clinical trials may underestimate treatment-related adverse events due to restrictive eligibility, limited sample size, and failure to anticipate selected toxicities. We evaluated the incidence and clinical determinants of CVAEs in real-world population on ICI therapy. Patients and methods Among 2 687 301 patients diagnosed with cancer from 2011 to 2018, 16 574 received ICIs for any cancer. Patients in the ICI and non-ICI cohorts were matched in a 1 : 1 ratio according to age, sex, National Cancer Institute comorbidity score, and primary cancer. The non-ICI cohort was stratified into patients who received chemotherapy (N = 2875) or targeted agents (N = 4611). All CVAEs, non-cardiac immune-related adverse events occurring after treatment initiation, baseline comorbidities, and treatment details were identified and analyzed using diagnosis and billing codes. Results Median age was 61 and 65 years in the ICI and non-ICI cohorts, respectively (P < 0.001). ICI patients were predominantly male (P < 0.001). Lung cancer (43.1%), melanoma (30.4%), and renal cell carcinoma (9.9%) were the most common cancer types. CVAE diagnoses in our dataset by incidence proportion (ICI cohort) were stroke (4.6%), heart failure (3.5%), atrial fibrillation (2.1%), conduction disorders (1.5%), myocardial infarction (0.9%), myocarditis (0.05%), vasculitis (0.05%), and pericarditis (0.2%). Anti-cytotoxic T-lymphocyte-associated protein 4 increased the risk of heart failure [versus anti-programmed cell death protein 1; hazard ratio (HR), 1.9; 95% confidence interval (CI) 1.27-2.84] and stroke (HR, 1.7; 95% CI 1.3-2.22). Pneumonitis was associated with heart failure (HR, 2.61; 95% CI 1.23-5.52) and encephalitis with conduction disorders (HR, 4.35; 95% CI 1.6-11.87) in patients on ICIs. Advanced age, primary cancer, nephritis, and anti-cytotoxic T-lymphocyte-associated protein 4 therapy were commonly associated with CVAEs in the adjusted Cox proportional hazards model. Conclusions Our findings underscore the importance of risk stratification and cardiovascular monitoring for patients on ICI therapy. Patient claims data across the United States were used to study cardiovascular adverse events (CVAEs) after ICI treatment. Patients on ICI treatment for advanced cancer have a higher incidence of CVAEs than previously reported. Median time to CVAE onset was significantly shorter with ICIs (~3 months) than with non-ICI systemic therapy (~8 months). Anti-CTLA-4 monotherapy or combination had a higher risk of heart failure and stroke than anti-PD-1 therapy (1.5-2 folds). Age, male sex, cancer type, nephritis, pneumonitis, and anti-CTLA-4 therapy were associated with a higher risk of CVAEs.
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Affiliation(s)
- P Jain
- University Hospitals, Seidman Cancer Center, Case Comprehensive Cancer Center, CWRU School of Medicine, Cleveland, USA.
| | | | - A Guha
- Harrington Heart and Vascular Institute, Cleveland, USA
| | - C Jain
- Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, USA
| | - N Patil
- Research and Education Institute, University Hospitals Health System, Cleveland, USA
| | - T Shen
- Layer 6 AI, Toronto, Canada
| | | | | | - K Margolin
- Department of Medical Oncology, City of Hope, Duarte, USA
| | - M Ernstoff
- ImmunoOncology Branch, Developmental Therapeutics Program, Division of Cancer Diagnosis and Treatment, National Cancer Institute, Bethesda, USA
| | - V Velcheti
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, USA
| | - J Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, CWRU School of Medicine, Cleveland, USA; Research and Education, University Hospitals Health System, Cleveland, USA
| | - A Dowlati
- University Hospitals, Seidman Cancer Center, Case Comprehensive Cancer Center, CWRU School of Medicine, Cleveland, USA
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Bellastella G, Carbone C, Scappaticcio L, Cirillo P, Troiani T, Morgillo F, Vietri MT, Della Corte CM, De Falco V, Napolitano S, Maiorino MI, De Bellis A, Esposito K. Hypothalamic-Pituitary Autoimmunity in Patients Treated with Anti-PD-1 and Anti-PD-L1 Antibodies. Cancers (Basel) 2021; 13:cancers13164036. [PMID: 34439190 PMCID: PMC8391584 DOI: 10.3390/cancers13164036] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 02/01/2023] Open
Abstract
Simple Summary The aim of this study is to search for APA and AHA and related pituitary dysfunction in patients treated with immunotherapy. APA and AHA could represent markers for early detection of patients at risk of developing pituitary deficiencies related to immune checkpoint inhibitors and undergoing closer follow-up. Furthermore, this study aims to evaluate the correlation between the presence of AHA and APA and the clinical response to checkpoint inhibitor therapy. However, further prospective studies will be needed to confirm our results. Abstract Background: Autoimmune hypophysitis is a frequent immune-related adverse event (irAE) in cancer patients treated with immunecheckpoint inhibitors. Studies seeking anti-pituitary (APA) and anti-hypothalamus (AHA) antibodies in patients treated with anti-PD-1 and anti-PD-L1 are scarce. The aim of this study is to search for APA and AHA and related pituitary dysfunction in patients treated with these agents. Methods:Cross-sectional and preliminary longitudinal studies were conducted at the Medical Oncology Unit and Endocrinology and Metabolic Diseases Unit of the University of Campania “Luigi Vanvitelli”. Fifty-four cancer patients on treatments with anti-PD-1 or anti-PD-L1 (Group 1) and 50 healthy controls were enrolled for a cross-sectional study; 13 cancer patients (Group 2) were enrolled for our preliminary longitudinal study. APA/AHA titers and changes in biochemical and hormonal profile were evaluated in Group 1; in Group 2, they were evaluated before and after nine weeks from the start of immunotherapy. Results: Patients of Group 1 showed a higher prevalence of APA and AHA than controls: 21 of them had APA, 16 had AHA, and 11 had both autoantibodies. In total, 7 of 13 patients in Group 2 became APA-positive and 3 became AHA-positive after nine weeks of immunotherapy, showing an increase in prolactin and a decrease in ACTH and IGF-1 levels compared with basal values. Conclusions:Anti-pituitary and anti-hypothalamus antibodies seem to play a pivotal role in hypothalamic–pituitary autoimmunity and secondary endocrine-related alterations evoked by anti-PD-1 and PD-L1 antibodies.
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Affiliation(s)
- Giuseppe Bellastella
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
- Correspondence: or ; Tel.: +39-081-566-5289
| | - Carla Carbone
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
| | - Lorenzo Scappaticcio
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
| | - Paolo Cirillo
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
| | - Teresa Troiani
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (T.T.); (F.M.); (C.M.D.C.); (V.D.F.); (S.N.)
| | - Floriana Morgillo
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (T.T.); (F.M.); (C.M.D.C.); (V.D.F.); (S.N.)
| | - Maria Teresa Vietri
- Unit of Clinical and Molecular Pathology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Carminia Maria Della Corte
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (T.T.); (F.M.); (C.M.D.C.); (V.D.F.); (S.N.)
| | - Vincenzo De Falco
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (T.T.); (F.M.); (C.M.D.C.); (V.D.F.); (S.N.)
| | - Stefania Napolitano
- Medical Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (T.T.); (F.M.); (C.M.D.C.); (V.D.F.); (S.N.)
| | - Maria Ida Maiorino
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
| | - Annamaria De Bellis
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.C.); (L.S.); (P.C.); (M.I.M.); (A.D.B.)
| | - Katherine Esposito
- Diabetes Unit, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
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Wu X, Kang X, Zhang X, Xie W, Su Y, Liu X, Guo L, Guo E, Li F, Hu D, Qin X, Fu Y, Peng W, Jia J, Wang C. WEE1 inhibitor and ataxia telangiectasia and RAD3-related inhibitor trigger stimulator of interferon gene-dependent immune response and enhance tumor treatment efficacy through programmed death-ligand 1 blockade. Cancer Sci 2021; 112:4444-4456. [PMID: 34382294 PMCID: PMC8586668 DOI: 10.1111/cas.15108] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/29/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022] Open
Abstract
WEE1 plays an important role in the regulation of cell cycle G2/M checkpoints and DNA damage response (DDR). Inhibition of WEE1 can increase the instability of the genome and have anti–tumor effects in some solid tumors. However, it has certain limitations for multiple cancer cells from different lineages. Therefore, we consider the use of synthetic lethal interactions to enhance the therapeutic effect. Our experiments proved that WEE1 inhibitor (WEE1i) can activate the ataxia telangiectasia and RAD3‐related (ATR) pathway and that blockage of ATR dramatically sensitized the WEE1i‐induced cell death. The tumor‐selective synthetic lethality between bioavailable WEE1 and ATR inhibitors led to tumor remission in vivo. Mechanistically, the combination promoted the accumulation of cytosolic double‐strand DNA, which subsequently activated the stimulator of the interferon gene (STING) pathway and induced the production of type I interferon and CD8+ T cells, thereby inducing anti–tumor immunity. Furthermore, our study found that immune checkpoint programmed death‐ligand 1 is upregulated by the combination therapy, and blocking PD‐L1 further enhances the effect of the combination therapy. In summary, as an immunomodulator, the combination of WEE1i with ATR inhibitor (ATRi) and immune checkpoint blockers provides a potential new approach for cancer treatment.
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Affiliation(s)
- Xue Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyan Kang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxiao Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wan Xie
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lili Guo
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ensong Guo
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fuxia Li
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Dianxing Hu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Qin
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Fu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenju Peng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiedong Jia
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Changyu Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zouein J, Kesrouani C, Kourie HR. PD-L1 expression as a predictive biomarker for immune checkpoint inhibitors: between a dream and a nightmare. Immunotherapy 2021; 13:1053-1065. [PMID: 34190579 DOI: 10.2217/imt-2020-0336] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PD-L1 is an important predictive biomarker for treatment by immune checkpoint inhibitors (ICIs). ICIs are now indicated for the treatment of various cancer depending on the level of expression of PD-L1 on tumor cells. PD-L1 testing is done using immunohistochemistry with five different assays approved as companion diagnostic for ICIs. However, these assays have different score reporting methods and do not accurately measure PD-L1 expression. Exosomal PD-L1 testing has recently emerged as an alternative for cell-surface PD-L1 testing however studies are still premature and more extensive knowledge about this new potential biomarker is needed.
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Affiliation(s)
- Joseph Zouein
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carole Kesrouani
- Department of Pathology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Buyansky D, Fallaha C, Gougeon F, Pépin MN, Cailhier JF, Beaubien-Souligny W. Acute Tubulointerstitial Nephritis in a Patient on Anti-Programmed Death-Ligand 1 Triggered by COVID-19: A Case Report. Can J Kidney Health Dis 2021; 8:20543581211014745. [PMID: 34046182 PMCID: PMC8138284 DOI: 10.1177/20543581211014745] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/05/2021] [Indexed: 01/22/2023] Open
Abstract
Rationale: Immune checkpoint inhibitors are monoclonal antibodies used in the treatment of various
types of cancers. The downside of using such molecules is the potential risk of
developing immune-related adverse events. Factors that trigger these autoimmune side
effects are yet to be elucidated. Although any organ can potentially be affected, kidney
involvement is usually rare. In this case report, we describe the first known instance
of a patient being treated with an inhibitor of programmed death-ligand 1 (anti-PD-L1, a
checkpoint inhibitor) who develops acute tubulointerstitial nephritis after contracting
the severe acute respiratory syndrome coronavirus 2. Presenting concerns of the patient: A 62-year-old patient, on immunotherapy treatment for stage 4 squamous cell carcinoma,
presents to the emergency department with symptoms of lower respiratory tract infection.
Severe acute kidney injury is discovered with electrolyte imbalances requiring urgent
dialysis initiation. Further testing reveals that the patient has contracted the severe
acute respiratory syndrome coronavirus 2. Diagnosis: A kidney biopsy was performed and was compatible with acute tubulointerstitial
nephritis. Interventions: The patient was treated with high dose corticosteroid therapy followed by progressive
tapering. Outcomes: Rapid and sustained normalization of kidney function was achieved after completion of
the steroid course. Novel findings: We hypothesize that the viral infection along with checkpoint inhibitor use has created
a proinflammatory environment which led to a loss of self-tolerance to renal parenchyma.
Viruses may play a more important role in the pathogenesis of autoimmunity in this
patient population than was previously thought.
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Affiliation(s)
| | | | - François Gougeon
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, Québec, Canada
| | - Marie-Noëlle Pépin
- Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Québec, Canada
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Jebbawi F, Bellanger AP, Lunström-Stadelmann B, Rufener R, Dosch M, Goepfert C, Gottstein B, Millon L, Grandgirard D, Leib SL, Beldi G, Wang J. Innate and adaptive immune responses following PD-L1 blockade in treating chronic murine alveolar echinococcosis. Parasite Immunol 2021; 43:e12834. [PMID: 33754355 DOI: 10.1111/pim.12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/10/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) immune checkpoint blockade are efficacious in certain cancer therapies. OBJECTIVES The present study aimed to provide a picture about the development of innate and adaptive immune responses upon PD-L1 blockade in treating chronic murine AE. METHODS Immune treatment started at 6 weeks post-E. multilocularis infection, and was maintained for 8 weeks with twice per week anti-PD-L1 administration (intraperitoneal). The study included an outgroup-control with mice perorally medicated with albendazole 5 d/wk, and another one with both treatments combined. Assessment of treatment efficacy was based on determining parasite weight, innate and adaptive immune cell profiles, histopathology and liver tissue cytokine levels. RESULTS/CONCLUSIONS Findings showed that the parasite load was significantly reduced in response to PD-L1 blockade, and this blockade (a) contributed to T-cell activity by increasing CD4+ /CD8+ effector T cells, and decreasing Tregs; (b) had the capacity to restore DCs and Kupffer cells/Macrophages; (c) suppressed NKT and NK cells; and thus (d) lead to an improved control of E. multilocularis infection in mice. This study suggests that the PD-L1 pathway plays an important role by regulating adaptive and innate immune cells against E. multilocularis infection, with significant modulation of tissue inflammation.
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Affiliation(s)
- Fadi Jebbawi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Anne-Pauline Bellanger
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Britta Lunström-Stadelmann
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Reto Rufener
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Michel Dosch
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Christine Goepfert
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Animal Pathology, COMPATH, University of Bern, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Laurence Millon
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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