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Chiru ED, Oseledchyk A, Schoetzau A, Kurzeder C, Mosimann R, Vetter M, Grašič Kuhar C. Application of a 21-Gene Recurrence Score in a Swiss Single-Center Breast Cancer Population: A Comparative Analysis of Treatment Administration before and after TAILORx. Diagnostics (Basel) 2023; 14:97. [PMID: 38201405 PMCID: PMC10795714 DOI: 10.3390/diagnostics14010097] [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: 11/03/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024] Open
Abstract
In patients with hormone receptor positive, human epidermal receptor 2 negative (HR+/HER2-) negative breast cancer (BC), the TAILORx study showed the benefit of adding chemotherapy (CHT) to endocrine therapy (ET) in a subgroup of patients under 50 years with an intermediate Oncotype DX recurrence score (RS 11-25). The aim of the present study was to determine if the TAILORx findings, including the changes in the RS categories, impacted CHT use in the intermediate RS (11-25) group in daily practice, as well as to identify the main factors for CHT decisions. We conducted a retrospective study on 326 BC patients (59% node-negative), of which 165 had a BC diagnosis before TAILORx (Cohort A) and 161 after TAILORx publication (Cohort B). Changes in the RS categories led to shifts in patient population distribution, thereby leading to a 40% drop in the low RS (from 60% to 20%), which represented a doubling in the intermediate RS (from 30% to 60%) and an increase of 5% in the high RS (from 8-10% to 15%). The overall CHT recommendation and application did not differ significantly between cohort B when compared with A (19% vs. 22%, resp., p = 0.763). In the intermediate RS (11-25), CHT use decreased by 5%, while in the high-risk RS category (>25), there was an increase of 13%. The tumor board recommended CHT for 90% of the patients according to the new RS guidelines in cohort A and for 85% in cohort B. The decision for CHT recommendation was based on age (OR 0.93, 95% CI 0.08-0.97, p = 0.001), nodal stage (OR 4.77, 95% CI 2.03-11.22, p < 0.001), and RS categories (RS 11-25 vs. RS 0-10: OR 0.06 (95% CI 0.02-0.17), p < 0.001; RS > 26 vs. RS 11-25: OR 618.18 95% CI 91.64-4169.91, p < 0.001), but did not depend on the cohort. In conclusion, while the tumor board recommendation for CHT decreased in the intermediate RS category, there was an increase being reported in the high RS category, thus leading to overall minor changes in CHT application. As expected, among the younger women with intermediate RS and unfavorable histopathological factors, CHT use increased.
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Affiliation(s)
- Elena Diana Chiru
- Medical Oncology, Basel University Hospital, 4051 Basel, Switzerland; (A.O.); (M.V.)
- Center of Oncology and Hematology, Cantonal Hospital Baselland, 4410 Liestal, Switzerland
| | - Anton Oseledchyk
- Medical Oncology, Basel University Hospital, 4051 Basel, Switzerland; (A.O.); (M.V.)
| | - Andreas Schoetzau
- Department of Biomedicine, Basel University, 4051 Basel, Switzerland;
| | | | - Raphael Mosimann
- Faculty of Medicine, Basel Medical University, 4051 Basel, Switzerland;
| | - Marcus Vetter
- Medical Oncology, Basel University Hospital, 4051 Basel, Switzerland; (A.O.); (M.V.)
- Center of Oncology and Hematology, Cantonal Hospital Baselland, 4410 Liestal, Switzerland
- Department of Gynecologic Oncology, Basel University Hospital, 4051 Basel, Switzerland;
| | - Cvetka Grašič Kuhar
- Department of Gynecologic Oncology, Basel University Hospital, 4051 Basel, Switzerland;
- Medical Oncology Department, Institute of Oncology Ljubljana, SI-1000 Ljubljana, Slovenia
- Faculty of Medicine Ljubljana, Korytkova 2, SI-1000 Ljubljana, Slovenia
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Wallrabenstein T, Oseledchyk A, Daetwyler E, Rochlitz C, Vetter M. Upfront Taxane Could Be Superior to Pegylated Liposomal Doxorubicin (PLD): A Retrospective Real-World Analysis of Treatment Sequence Taxane-PLD versus PLD-Taxane in Patients with Metastatic Breast Cancer. Cancers (Basel) 2023; 15:4953. [PMID: 37894320 PMCID: PMC10605604 DOI: 10.3390/cancers15204953] [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: 09/13/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Background: Patients with endocrine-resistant metastatic breast cancer (MBC) require cytostatic therapy. Single-agent taxanes and anthracyclines, including pegylated liposomal doxorubicin (PLD), are standard treatment options. There are no prospective data regarding optimal treatment sequences, and real-world data regarding both treatment options are limited. Methods: We analyzed electronic records of all patients with Her2-negative MBC treated with either first-line PLD or first-line taxane and subsequent crossover at the University Hospital Basel between 2003 and 2021. The primary endpoint was time to next chemotherapy or death (TTNC). Secondary endpoints were overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). We used the Kaplan-Meyer method and logrank test to compare time-to-event endpoints and the Fisher exact test to compare discrete variables. Results: We retrospectively identified 42 patients with Her2-negative MBC who have received either single-agent PLD or single-agent taxane as first-line chemotherapy with subsequent crossover, including 23 patients who received first-line PLD and 19 patients who received first-line taxane. Baseline characteristics were similar between treatment groups. Treatment sequence PLD-taxane was significantly inferior to taxane-PLD regarding all endpoints: median TTNC 4.9 vs. 9.9 months (p = 0.006), median OS 17.8 vs. 24.6 months (p = 0.05), median PFS 4.4 vs. 9.0 months (p = 0.005), and ORR 13% vs. 53% (p = 0.01). Conclusions: Here, we report a first retrospective head-to-head comparison of the treatment sequence PLD-taxane versus taxane-PLD in patients with MBC, showing a substantial advantage of using taxanes first, followed by PLD. An inherent treatment bias in favor of first-line taxanes cannot be excluded, thus calling for prospective validation.
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Affiliation(s)
- Till Wallrabenstein
- University Hospital Basel, Medical Oncology, Petersgraben 4, 4031 Basel, Switzerland (M.V.)
- University Medical Center Freiburg, Hematology and Oncology, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Anton Oseledchyk
- University Hospital Basel, Medical Oncology, Petersgraben 4, 4031 Basel, Switzerland (M.V.)
| | - Eveline Daetwyler
- University Hospital Basel, Medical Oncology, Petersgraben 4, 4031 Basel, Switzerland (M.V.)
| | - Christoph Rochlitz
- University Hospital Basel, Medical Oncology, Petersgraben 4, 4031 Basel, Switzerland (M.V.)
| | - Marcus Vetter
- University Hospital Basel, Medical Oncology, Petersgraben 4, 4031 Basel, Switzerland (M.V.)
- Zentrum Onkologie & Hämatologie, Tumorzentrum, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Medical Faculty, University Basel, 4031 Basel, Switzerland
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Chiru ED, Grasic Kuhar C, Oseledchyk A, Schötzau A, Gonzalez MJ, Kurzeder C, Vetter M. Clinical application of the 21-gene oncotype recurrence score in an older cohort: A single center experience. Transl Oncol 2023; 36:101724. [PMID: 37480708 PMCID: PMC10375846 DOI: 10.1016/j.tranon.2023.101724] [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: 01/11/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND In early luminal breast cancer, the Oncotype DX® Recurrence Score (RS) prognostic and predictive value with regards to chemotherapy (CHT) application benefit has been broadly validated. In older patients its value has not been deeply addressed. This study aimed to evaluate the benefits of RS testing and to look at differences in treatment allocation for these patients when compared with younger ones. METHODS We included data from consecutive patients with early luminal HER2-negative breast cancer, treated between 2010 and 2022 at the University Hospital Basel and Cantonal Hospital Baselland, Switzerland. The older cohort included 63 (19%) patients aged ≥70, and the younger cohort 263 (81%) patients aged <70. RESULTS Older breast cancer patients had more co-morbidities (N = 36, 57% vs. N = 92, 35%, p = 0.002) and a higher clinical risk status (N = 49, 78% vs. N = 155, 59%; p = 0.01) when compared to younger patients. Histopathologic characteristics were significantly different between the two cohorts. Although older patients had a higher clinical risk status (78% vs. 59%) (p = 0.01), most of them (74%) received no CHT. Specifically, adjuvant CHT was administered less frequently in older than in younger patients (13% vs. 22%; p = 0.01). Moreover, older patients were less likely to complete CHT (>4 cycles: 78% vs. 97%). CONCLUSION Breast cancer patients aged ≥70 have higher clinical risk status, more co-morbidities, higher clinical stage (driven by larger tumor size), and more often RS ≥26. However, they receive fewer adjuvant RT and CHT than those aged <70. RS maintains its independent prognostic value in older patients. However, assessing the predictive value of additional CHT benefit remains challenging due to significant differences in CHT administration. Although therapy decision-making in older patients with breast cancer still follows RS-based guidelines, clinical practice indicates an individualized treatment approach.
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Affiliation(s)
- E D Chiru
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - C Grasic Kuhar
- Medical Oncology Department, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Oseledchyk
- Medical Oncology, Basel University Hospital, Basel, Switzerland
| | - A Schötzau
- Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M J Gonzalez
- Adullam Hospital and care centers, Basel, Switzerland
| | - C Kurzeder
- Breast Center, Basel University Hospital, Basel, Switzerland; Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M Vetter
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland; Breast Center, Basel University Hospital, Basel, Switzerland.
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Andreou C, Plakas K, Berisha N, Gigoux M, Rosch LE, Mirsafavi R, Oseledchyk A, Pal S, Zamarin D, Merghoub T, Detty MR, Kircher MF. Correction: Multiplexed molecular imaging with surface enhanced resonance Raman scattering nanoprobes reveals immunotherapy response in mice via multichannel image segmentation. Nanoscale Horiz 2023; 8:1122. [PMID: 37382592 DOI: 10.1039/d3nh90027d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Correction for 'Multiplexed molecular imaging with surface enhanced resonance Raman scattering nanoprobes reveals immunotherapy response in mice via multichannel image segmentation' by Chrysafis Andreou et al., Nanoscale Horiz., 2022, 7, 1540-1552, https://doi.org/10.1039/d2nh00331g.
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Affiliation(s)
- Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Electrical and Computer Engineering, University of Cyprus, Nicosia, 1678 Nicosia, Cyprus.
| | - Konstantinos Plakas
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Naxhije Berisha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
- Department of Chemistry, The Graduate Center of the City University of New York, New York, NY 10016, USA
| | - Mathieu Gigoux
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Lauren E Rosch
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Rustin Mirsafavi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Suchetan Pal
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Dmitriy Zamarin
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Taha Merghoub
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Michael R Detty
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Moritz F Kircher
- Department of Imaging, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA
- Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02215, USA
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Wallrabenstein T, Daetwyler E, Oseledchyk A, Rochlitz C, Vetter M. Pegylated liposomal doxorubicin (PLD) in daily practice-A single center experience of treatment with PLD in patients with comorbidities and older patients with metastatic breast cancer. Cancer Med 2023. [PMID: 37148541 DOI: 10.1002/cam4.6041] [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: 12/08/2022] [Revised: 04/16/2023] [Accepted: 04/23/2023] [Indexed: 05/08/2023] Open
Abstract
PURPOSE Real-world data about pegylated liposomal doxorubicin (PLD) in patients with metastatic breast cancer (MBC) are limited. We have aimed to highlight the role of PLD in daily practice focusing on older patients and patients with comorbidities with MBC. METHODS We analyzed electronic records of all patients with advanced/metastatic breast cancer treated with single-agent PLD at the University Hospital Basel between 2003 and 2021. Primary endpoint was time to next chemotherapy or death (TTNC). Secondary endpoints were overall survival (OS), progression-free survival (PFS), and overall response rate (ORR). We performed univariate and multivariate analysis for clinical variables. RESULTS 112 patients with MBC having received single-agent PLD in any treatment line were analyzed, including 34 patient who were older than 70 years and 61 patients with relevant comorbidities. Median TTNC, OS, and PFS for treatment with PLD were 4.6, 11.9, and 4.4 months, respectively. ORR was 13.6%. Age >70 years predicted shorter OS (median 11.2 months) in multivariate analysis (hazard ratio [HR] 1.83, 95% CI 1.07-3.11, p = 0.026). Age and comorbidities did not significantly affect other endpoints. Unexpectedly, hypertension predicted longer TTNC (8.3 months, p = 0.04) in univariate analysis, maintained in multivariate analysis as a trend for both TTNC (HR 0.62, p = 0.07) and OS (HR 0.63, p = 0.1). CONCLUSION Age predicted shorter OS significantly but median OS was not relevantly shorter in older patients. PLD remains a treatment option in patients with comorbidities and older patients with MBC. However, our real-world results of PLD appear underwhelming compared to relevant phase II trials through all age groups, pointing to an efficacy-effectiveness gap, possibly due to sampling bias.
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Affiliation(s)
- T Wallrabenstein
- Medical Oncology, University Hospital Basel, Basel, Switzerland
- Hematology/Oncology, University Medical Center Freiburg, Freiburg, Germany
| | - E Daetwyler
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - A Oseledchyk
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - C Rochlitz
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - M Vetter
- Medical Oncology, University Hospital Basel, Basel, Switzerland
- Medical Oncology, Kantonsspital Baselland, Liestal, Switzerland
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Chiru ED, Kuhar CG, Oseledchyk A, Kurzeder C, Vetter M. Abstract P5-14-13: Benefits of Oncotype DX genomic screening in a geriatric vs. non-geriatric cohort. Analyzing key factors in therapy decision making process. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-14-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction In early luminal HER2 negative breast cancer Oncotype DX® Recurrence-Score (RS) has been broadly validated in pre- and postmenopausal patients and can predict prognosis and benefit of chemotherapy. Its value in elderly breast cancer populations has not been deeply addressed. This study analyses clinical and pathologic factors, RS distribution and outcomes in an elderly vs. non-elderly breast cancer population with the purpose of establishing RS added value to the therapy decision-making process in a geriatric cohort.
Methods This is a retrospective analysis of available data from patients with early luminal HER2 negative breast cancer treated at the University Hospital Basel and the Cantonal Hospital Baselland between 2010 and 2022. Cohort A (A) consists of patients < 70 years old and cohort B (B) of patients aged ≥70 years. At moment of decision for adjuvant treatment all patients had known RS result.
Results A and B included 266 (81%) and 60 (19%) patients, respectively. The median age in A was 55.2 and in B, 74 years. The following clinical and pathologic factors were different in B vs. A: co-morbidities (55 % vs. 35%, p=0.005), BMI (BMI≥25 (overweight vs. normal, p=0.023), tumor size (31.3 mm vs 23.6 mm p=0.021). Geriatric patients also tended to have a clinically higher risk status (83% vs. 70%; p=0.05). There was a trend for a higher mastectomy rate in B vs. A (41.7% vs. 29%, p=0.065), significantly less radiotherapy use (65% vs. 81%, p=0.009) and more osteo-oncologic treatment (61% vs 43%, p=0.013). RS distribution was not significantly different between cohorts (A vs. B was: RS 1-15: 44.3% vs 41.7%, RS 16-25 41.2% vs 35% and RS≥26 14.5% vs 23.3%; p=0.234). Adjuvant chemotherapy was performed in 11.5% of B and 22.9% of A (p=0.116) and adjuvant endocrine therapy in 98.3% of B vs. 93.5% of A (p=p=0.214). Tumor board suggested systemic treatment was not implemented in 22% vs 15 %, (B vs. A; p =0.087). With a median follow-up of 36.6 months, recurrence rate was higher, but not statistically significant in B vs. A (10% vs 6%, p=0.259). Relapse rate was higher with RS≥26 vs. RS 0-25 (13.5% in B vs. 5.7% in A; p=0.043).
Conclusions Older breast cancer patients tend to have higher clinical risk status, more co-morbidities and higher BMI. RS distribution was not significantly different between the two cohorts, however higher RS did pose a higher relapse rate for older patients in our cohort. Although RS based guidelines, still apply in therapy decision making in the case of geriatric breast cancer patients, clinical practice points to a rather individualized treatment in which all clinical and pathological factors are weighted.
Citation Format: Elena D Chiru, Cvetka Grasic Kuhar, Anton Oseledchyk, Christian Kurzeder, Marcus Vetter. Benefits of Oncotype DX genomic screening in a geriatric vs. non-geriatric cohort. Analyzing key factors in therapy decision making process [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-14-13.
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Affiliation(s)
- Elena D Chiru
- 1Basel University Hospital and Cantonal Hospital Baselland
| | | | | | - Christian Kurzeder
- 4Breast Center, University Hospital of Basel, Basel, Switzerland, Basel-Stadt, Switzerland
| | - Marcus Vetter
- 5Basel University Hospital and Cantonal Hospital Baselland, Basel, Basel-Landschaft, Switzerland
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Andreou C, Plakas K, Berisha N, Gigoux M, Rosch LE, Mirsafavi R, Oseledchyk A, Pal S, Zamarin D, Merghoub T, Detty MR, Kircher MF. Multiplexed molecular imaging with surface enhanced resonance Raman scattering nanoprobes reveals immunotherapy response in mice via multichannel image segmentation. Nanoscale Horiz 2022; 7:1540-1552. [PMID: 36285605 PMCID: PMC10360075 DOI: 10.1039/d2nh00331g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Visualizing the presence and distribution of multiple specific molecular markers within a tumor can reveal the composition of its microenvironment, inform diagnosis, stratify patients, and guide treatment. Raman imaging with multiple molecularly-targeted surface enhanced Raman scattering (SERS) nanoprobes could help investigate emerging cancer treatments preclinically or enable personalized treatment assessment. Here, we report a comprehensive strategy for multiplexed imaging using SERS nanoprobes and machine learning (ML) to monitor the early effects of immune checkpoint blockade (ICB) in tumor-bearing mice. We used antibody-functionalized SERS nanoprobes to visualize 7 + 1 immunotherapy-related targets simultaneously. The multiplexed images were spectrally resolved and then spatially segmented into superpixels based on the unmixed signals. The superpixels were used to train ML models, leading to the successful classification of mice into treated and untreated groups, and identifying tumor regions with variable responses to treatment. This method may help predict treatment efficacy in tumors and identify areas of tumor variability and therapy resistance.
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Affiliation(s)
- Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Electrical and Computer Engineering, University of Cyprus, Nicosia, 1678 Nicosia, Cyprus.
| | - Konstantinos Plakas
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Naxhije Berisha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
- Department of Chemistry, The Graduate Center of the City University of New York, New York, NY 10016, USA
| | - Mathieu Gigoux
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Lauren E Rosch
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Rustin Mirsafavi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Suchetan Pal
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Dmitriy Zamarin
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Taha Merghoub
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA
| | - Michael R Detty
- Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, New York 14260-3000, USA
| | - Moritz F Kircher
- Department of Imaging, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA
- Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02215, USA
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Chiru E, Grasic Kuhar C, Oseledchyk A, Kurzeder C, Vetter M. 21-Gene Oncotype DX® Recurrence-Score benefits and application in elderly breast cancer patients. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00291-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Burman B, Ceglia N, Hirschhorn D, Budhu S, Mangarin L, Oseledchyk A, Bykov Y, McPherson A, Shah S, Wolchok J, Merghoub T, Zamarin D. Abstract 5217: Defining the balance of anti-viral and anti-tumor T cell responses to oncolytic virus therapy using single cell approaches. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Preclinical and clinical studies have shown that intratumoral oncolytic viruses (OVs) can potentiate host anti-tumor immunity and overcome resistance to immune checkpoint blockade, although clinical responses to OVs have been modest to date. While T cell infiltration of tumors is frequently cited as a measure of OV immunogenicity, this measure is non-specific as OVs elicit a strong virus-directed T cell response, and it remains unknown what proportion of T cells expanded by OV therapy are virus-specific vs. tumor-specific or how these T cells distribute across virus-treated and distant tumors. We employed oncolytic Newcastle disease virus (NDV) in a bilateral flank melanoma mouse model to identify and phenotypically characterize anti-viral and anti-tumor T cells using single cell (sc) RNA and T cell receptor (TCR) sequencing. Intratumoral NDV therapy to a single flank tumor resulted in increased infiltration of CD4+ and CD8+ T cells in the injected (enestic) and distant (non-enestic) tumors and increased the breadth of the TCR repertoire at both sites with preferential expansion of several dominant clonotypes. There was substantial expansion of the proportion of T cell clonotypes shared between enestic and nonenestic tumors as well as the spleen, indicative of inter-tumor TCR repertoire normalization. In both treated and distant tumors, we observed a significant increase in the frequency of convergent TCR clonotypes, i.e. TCRs encoded by different nucleotide sequences that converge on the same amino acid sequence, implying that the presence of these TCRs in tumors is non-random. Using scRNA and paired TCR sequencing, we demonstrate that NDV therapy leads to expansion of unique clusters of terminally differentiated and activated CD4+ and CD8+ T cells associated with distinct TCR-based clonotypes. Notably, the predominant phenotypic clusters were distinct between the enestic and non-enestic tumors. Enestic tumors were dominated by CD8+ T cells exhibiting a signature associated with terminal dysfunction (PDCD1, LAG3, TOX), while the predominant expanded CD8+ T cells in non-enestic tumors exhibited an activation signature associated with high expression of cytolytic markers. While phenotypic states were conserved for the dominant TCR clones shared across the enestic and non-enestic tumors, TCRs unique to the non-enestic tumor were predominantly associated with an activated T cell state. Taken together, these studies highlight that T cells expanded by OV therapy exhibit unique functional states and TCRs in treated and distant tumors and imply that virus- and tumor-specific T cells may be identified by distinct TCR repertoires and phenotypes. Understanding the balance between virus- and tumor-directed T cells elicited by OV therapy will be key to engineering OVs and designing combination strategies that drive stronger tumor-directed T cell response.
Citation Format: Bharat Burman, Nicholas Ceglia, Daniel Hirschhorn, Sadna Budhu, Levi Mangarin, Anton Oseledchyk, Yonina Bykov, Andrew McPherson, Sohrab Shah, Jedd Wolchok, Taha Merghoub, Dmitriy Zamarin. Defining the balance of anti-viral and anti-tumor T cell responses to oncolytic virus therapy using single cell approaches [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5217.
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Affiliation(s)
- Bharat Burman
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Sadna Budhu
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | - Levi Mangarin
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | - Sohrab Shah
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jedd Wolchok
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | - Taha Merghoub
- 1Memorial Sloan Kettering Cancer Center, New York, NY
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Oseledchyk A, Gemignani ML, Zhou QC, Iasonos A, Elahjji R, Adamou Z, Feit N, Goldfarb SB, Long Roche K, Sonoda Y, Goldfrank DJ, Chi DS, Saban SS, Broach V, Abu-Rustum NR, Carter J, Leitao M, Zivanovic O. Surgical ovarian suppression for adjuvant treatment in hormone receptor positive breast cancer in premenopausal patients. Int J Gynecol Cancer 2020; 31:222-231. [PMID: 33273020 DOI: 10.1136/ijgc-2020-001966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Ovarian suppression is recommended to complement endocrine therapy in premenopausal women with breast cancer and high-risk features. It can be achieved by either medical ovarian suppression or therapeutic bilateral salpingo-oophorectomy. Our objective was to evaluate characteristics of patients with stage I-III hormone receptor positive primary breast cancer who underwent bilateral salpingo-oophorectomy at our institution. MATERIALS AND METHODS Premenopausal women with stage I-III hormone receptor positive primary breast cancer diagnosed between January 2010 and December 2014 were identified from a database. Patients with confirmed BRCA1/2 mutations were excluded. Distribution of characteristics between treatment groups was assessed using χ2 test and univariate logistic regression. A multivariate model was based on factors significant on univariate analysis. RESULTS Of 2740 women identified, 2018 (74%) received endocrine treatment without ovarian ablation, 516 (19%) received endocrine treatment plus ovarian ablation, and 206 (7.5%) did not receive endocrine treatment. Among patients undergoing ovarian ablation 282/516 (55%) received medical ovarian suppression, while 234 (45%) underwent bilateral salpingo-oophorectomy. By univariate logistic analyses, predictors for ovarian ablation were younger age (OR 0.97), histology (other vs ductal: OR 0.23), lymph node involvement (OR 1.89), higher International Federation of Gynecology and Obstetrics (FIGO) stage (stage II vs I: OR 1.48; stage III vs I: OR 2.86), higher grade (grade 3 vs 1: OR 3.41; grade 2 vs 1: OR 2.99), chemotherapy (OR 1.52), and more recent year of diagnosis (2014 vs 2010; OR 1.713). Only year of diagnosis, stage, and human epidermal growth factor receptor 2 (HER-2) treatment remained significant in the multivariate model. Within the cohort undergoing ovarian ablation, older age (OR 1.05) was associated with therapeutic bilateral salpingo-oophorectomy. Of 234 undergoing bilateral salpingo-oophorectomy, 12 (5%) mild to moderate adverse surgical events were recorded. CONCLUSIONS Bilateral salpingo-oophorectomy is used frequently as an endocrine ablation strategy. Older age was associated with bilateral salpingo-oophorectomy. Perioperative morbidity was acceptable. Evaluation of long-term effects and quality of life associated with endocrine ablation will help guide patient/provider decision-making.
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Affiliation(s)
- Anton Oseledchyk
- Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mary L Gemignani
- Breast Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Qin C Zhou
- Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alexia Iasonos
- Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rahmi Elahjji
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Zara Adamou
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Noah Feit
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shari B Goldfarb
- Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kara Long Roche
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yukio Sonoda
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Deborah J Goldfrank
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dennis S Chi
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sally S Saban
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Vance Broach
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nadeem R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jeanne Carter
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mario Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Oliver Zivanovic
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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11
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Pal S, Ray A, Andreou C, Zhou Y, Rakshit T, Wlodarczyk M, Maeda M, Toledo-Crow R, Berisha N, Yang J, Hsu HT, Oseledchyk A, Mondal J, Zou S, Kircher MF. DNA-enabled rational design of fluorescence-Raman bimodal nanoprobes for cancer imaging and therapy. Nat Commun 2019; 10:1926. [PMID: 31028250 PMCID: PMC6486596 DOI: 10.1038/s41467-019-09173-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
Recently, surface-enhanced Raman scattering nanoprobes have shown tremendous potential in oncological imaging owing to the high sensitivity and specificity of their fingerprint-like spectra. As current Raman scanners rely on a slow, point-by-point spectrum acquisition, there is an unmet need for faster imaging to cover a clinically relevant area in real-time. Herein, we report the rational design and optimization of fluorescence-Raman bimodal nanoparticles (FRNPs) that synergistically combine the specificity of Raman spectroscopy with the versatility and speed of fluorescence imaging. DNA-enabled molecular engineering allows the rational design of FRNPs with a detection limit as low as 5 × 10−15 M. FRNPs selectively accumulate in tumor tissue mouse cancer models and enable real-time fluorescence imaging for tumor detection, resection, and subsequent Raman-based verification of clean margins. Furthermore, FRNPs enable highly efficient image-guided photothermal ablation of tumors, widening the scope of the NPs into the therapeutic realm. Currently available Raman scanners are limited in speed to acquire images of clinically relevant sizes in cancer imaging. Here, the authors developed a DNA based design principle for Raman-Fluorescence bimodal nanoparticles and demonstrate real-time, high precision image-guided tumor resections and photothermal ablation of cancer.
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Affiliation(s)
- Suchetan Pal
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Chemistry, Indian Institute of Technology Bhilai, Raipur, Chhattisgarh, 492015, India
| | - Angana Ray
- Tata Institute of Fundamental Research, Hyderabad, Telangana, 500107, India
| | - Chrysafis Andreou
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Yadong Zhou
- Department of Chemistry, University of Central Florida, Orlando, FL, 32816, USA
| | - Tatini Rakshit
- Department of Bioengineering, New York University, New York, NY, 10010, USA
| | - Marek Wlodarczyk
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, New York, NY, 10016, USA
| | - Masatomo Maeda
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ricardo Toledo-Crow
- Advanced Science Research Center, City University of New York, New York, NY, 10031, USA
| | - Naxhije Berisha
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, New York, NY, 10016, USA
| | - Jiang Yang
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Hsiao-Ting Hsu
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Anton Oseledchyk
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jagannath Mondal
- Tata Institute of Fundamental Research, Hyderabad, Telangana, 500107, India
| | - Shengli Zou
- Department of Chemistry, University of Central Florida, Orlando, FL, 32816, USA
| | - Moritz F Kircher
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. .,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. .,Molecular Pharmacology Program, Sloan Kettering Institute, New York, NY, 10065, USA. .,Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA. .,Department of Imaging, Dana-Farber Cancer Institute, Boston, MA, 02215, USA.
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12
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Andreou C, Oseledchyk A, Nicolson F, Berisha N, Pal S, Kircher MF. Surface-enhanced Resonance Raman Scattering Nanoprobe Ratiometry for Detecting Microscopic Ovarian Cancer via Folate Receptor Targeting. J Vis Exp 2019. [PMID: 30958459 DOI: 10.3791/58389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ovarian cancer represents the deadliest gynecologic malignancy. Most patients present at an advanced stage (FIGO stage III or IV), when local metastatic spread has already occurred. However, ovarian cancer has a unique pattern of metastatic spread, in that tumor implants are initially contained within the peritoneal cavity. This feature could enable, in principle, the complete resection of tumor implants with curative intent. Many of these metastatic lesions are microscopic, making them hard to identify and treat. Neutralizing such micrometastases is believed to be a major goal towards eliminating tumor recurrence and achieving long-term survival. Raman imaging with surface enhanced resonance Raman scattering nanoprobes can be used to delineate microscopic tumors with high sensitivity, due to their bright and bioorthogonal spectral signatures. Here, we describe the synthesis of two 'flavors' of such nanoprobes: an antibody-functionalized one that targets the folate receptor - overexpressed in many ovarian cancers - and a non-targeted control nanoprobe, with distinct spectra. The nanoprobes are co-administered intraperitoneally to mouse models of metastatic human ovarian adenocarcinoma. All animal studies were approved by the Institutional Animal Care and Use Committee of Memorial Sloan Kettering Cancer Center. The peritoneal cavity of the animals is surgically exposed, washed, and scanned with a Raman microphotospectrometer. Subsequently, the Raman signatures of the two nanoprobes are decoupled using a Classical Least Squares fitting algorithm, and their respective scores divided to provide a ratiometric signal of folate-targeted over untargeted probes. In this way, microscopic metastases are visualized with high specificity. The main benefit of this approach is that the local application into the peritoneal cavity - which can be done conveniently during the surgical procedure - can tag tumors without subjecting the patient to systemic nanoparticle exposure. False positive signals stemming from non-specific binding of the nanoprobes onto visceral surfaces can be eliminated by following a ratiometric approach where targeted and non-targeted nanoprobes with distinct Raman signatures are applied as a mixture. The procedure is currently still limited by the lack of a commercial wide-field Raman imaging camera system, which once available will allow for the application of this technique in the operating theater.
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Affiliation(s)
| | | | - Fay Nicolson
- Department of Radiology, Memorial Sloan Kettering Cancer Center
| | - Naxhije Berisha
- Department of Radiology, Memorial Sloan Kettering Cancer Center; Department of Chemistry, The Graduate Center of the City University of New York
| | - Suchetan Pal
- Department of Radiology, Memorial Sloan Kettering Cancer Center
| | - Moritz F Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center; Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center; Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center; Gerstner Sloan Kettering Graduate School of Biomedical Sciences; Department of Radiology, Weill Cornell Medical College of Cornell University; Dana-Farber Cancer Institute and Harvard Medical Center;
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13
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Zamarin D, Ricca JM, Sadekova S, Oseledchyk A, Yu Y, Blumenschein WM, Wong J, Gigoux M, Merghoub T, Wolchok JD. PD-L1 in tumor microenvironment mediates resistance to oncolytic immunotherapy. J Clin Invest 2018; 128:5184. [PMID: 30277478 DOI: 10.1172/jci125039] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Oseledchyk A, Ricca JM, Gigoux M, Ko B, Redelman-Sidi G, Walther T, Liu C, Iyer G, Merghoub T, Wolchok JD, Zamarin D. Lysis-independent potentiation of immune checkpoint blockade by oncolytic virus. Oncotarget 2018; 9:28702-28716. [PMID: 29983890 PMCID: PMC6033351 DOI: 10.18632/oncotarget.25614] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/25/2018] [Accepted: 05/31/2018] [Indexed: 12/21/2022] Open
Abstract
Intratumoral therapy with oncolytic viruses is increasingly being explored as a strategy to potentiate an immune response against cancer, but it remains unknown whether such therapy should be restricted to cancers sensitive to virus-mediated lysis. Using Newcastle Disease Virus (NDV) as a model, we explore immunogenic potential of an oncolytic virus in bladder cancer, where existing immunotherapy with PD-1 and PD-L1-targeting antibodies to date has shown suboptimal response rates. Infection of human and mouse bladder cancer cells with NDV resulted in immunogenic cell death, activation of innate immune pathways, and upregulation of MHC and PD-L1 in all tested cell lines, including the cell lines completely resistant to NDV-mediated lysis. In a bilateral flank NDV-lysis-resistant syngeneic murine bladder cancer model, intratumoral therapy with NDV led to an increase of immune infiltration in both treated and distant tumors and a shift from an inhibitory to effector T cell phenotype. Consequently, combination of intratumoral NDV with systemic PD-1 or CTLA-4 blockade led to improved local and abscopal tumor control and overall survival. These findings encourage future clinical trials combining intratumoral NDV therapy with systemic immunomodulatory agents and underscore the rationale for such treatments irrespective of tumor cell sensitivity to NDV-mediated lysis.
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Affiliation(s)
- Anton Oseledchyk
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jacob M Ricca
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mathieu Gigoux
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brian Ko
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gil Redelman-Sidi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA
| | - Tyler Walther
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cailian Liu
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gopa Iyer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA
| | - Taha Merghoub
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jedd D Wolchok
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dmitriy Zamarin
- Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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15
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Oseledchyk A, Gennarelli RL, Leitao MM, Aghajanian CA, Iasonos A, Zivanovic O, Zamarin D. Adjuvant chemotherapy in patients with operable granulosa cell tumors of the ovary: a surveillance, epidemiology, and end results cohort study. Cancer Med 2018; 7:2280-2287. [PMID: 29667339 PMCID: PMC6010870 DOI: 10.1002/cam4.1447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 02/17/2018] [Accepted: 02/25/2018] [Indexed: 01/27/2023] Open
Abstract
Adjuvant chemotherapy is recommended for patients with resected high-risk adult granulosa cell tumors (GCT), although strong data to support this are lacking. The objective of this study was to assess the outcomes of GCT patients, with the specific focus on patients that received adjuvant chemotherapy with curative intent (stage I-III), reported in a large national cancer registry. Data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2013 were used for analysis. Patient and disease characteristics were extracted and analyzed for association with administration of chemotherapy. Impact on disease-specific survival (DSS) was analyzed using log-rank test. A total of 739 patients with surgically treated adult GCT were identified. Median age was 51 years. 570 (77%) patients were stage I, 87 (12%) were stage II, and 82 (11%) were stage III. Adjuvant chemotherapy was administered to 176 (24%) patients. Young age, higher stage, and hysterectomy were associated with chemotherapy administration. Higher disease stage was associated with decreased five-year DSS (IA/B 98.5%, IC 95.1%, II 86.1%, III 83.5%, P < 0.01). Notably, administration of adjuvant chemotherapy was not associated with improved five-year DSS (P = 0.45) regardless of disease stage (stage IA/B: 96% with chemotherapy vs. 99% without chemotherapy; P = 0.64), (stage IC: 97% with chemotherapy vs. 94% without chemotherapy; P = 0.49), (stage II: 89% with chemotherapy vs. 83% without chemotherapy; P = 0.56), (stage III: 73% with chemotherapy vs. 93% without chemotherapy; P = 0.18). In this analysis, chemotherapy was not found to be associated with improved DSS of patients with operable disease regardless of stage, questioning the role for adjuvant chemotherapy in GCT.
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Affiliation(s)
- Anton Oseledchyk
- Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkNew York10065
| | - Renee L. Gennarelli
- Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNew York10065
| | - Mario M. Leitao
- Gynecology ServiceDepartment of SurgeryMemorial Sloan‐Kettering Cancer CenterNew YorkNew York10065
- Weill Cornell Medical CollegeNew YorkNew York10065
| | - Carol A. Aghajanian
- Weill Cornell Medical CollegeNew YorkNew York10065
- Gynecologic Medical Oncology ServiceDepartment of MedicineMemorial Sloan‐Kettering Cancer CenterNew YorkNew York10065
| | - Alexia Iasonos
- Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNew York10065
| | - Oliver Zivanovic
- Gynecology ServiceDepartment of SurgeryMemorial Sloan‐Kettering Cancer CenterNew YorkNew York10065
- Weill Cornell Medical CollegeNew YorkNew York10065
| | - Dmitriy Zamarin
- Weill Cornell Medical CollegeNew YorkNew York10065
- Gynecologic Medical Oncology ServiceDepartment of MedicineMemorial Sloan‐Kettering Cancer CenterNew YorkNew York10065
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16
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Oseledchyk A, Leitao MM, Konner J, O'Cearbhaill RE, Zamarin D, Sonoda Y, Gardner GJ, Long Roche K, Aghajanian CA, Grisham RN, Brown CL, Snyder A, Chi DS, Soslow RA, Abu-Rustum NR, Zivanovic O. Adjuvant chemotherapy in patients with stage I endometrioid or clear cell ovarian cancer in the platinum era: a Surveillance, Epidemiology, and End Results Cohort Study, 2000-2013. Ann Oncol 2018; 28:2985-2993. [PMID: 28950307 DOI: 10.1093/annonc/mdx525] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 12/22/2022] Open
Abstract
Background We sought to evaluate the impact of adjuvant chemotherapy on overall survival (OS) in patients with stage I endometrioid epithelial ovarian cancer (EEOC) or ovarian clear cell cancer (OCCC) using a national database. Patients and methods The Surveillance, Epidemiology, and End Results database was used to identify patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I EEOC or OCCC from 2000 to 2013. We sought to identify predictors of chemotherapy use and to assess the impact of chemotherapy on OS in these patients. OS was compared using the log-rank test and the Cox proportional hazards model. Results In all, 3552 patients with FIGO stage I EEOC and 1995 patients with stage I OCCC were identified. Of the 1600 patients (45%) with EEOC who underwent adjuvant chemotherapy, the 5-year OS rate was 90%, compared with 89% for those who did not undergo adjuvant chemotherapy (P = 0.807). Of the 1374 (69%) patients with OCCC who underwent adjuvant chemotherapy, the 5-year OS rate was 85%, compared with 83% (P = 0.439) for those who did not undergo adjuvant chemotherapy. Chemotherapy use was associated with younger age, higher substage, and more recent year of diagnosis for both the EEOC and OCCC groups. Only in the subgroup of patients with FIGO substage IC, grade 3 EEOC (n = 282) was chemotherapy associated with an improved 5-year OS-81% compared with 62% (P = 0.003) in untreated patients (HR: 0.583; 95% CI: 0.359-0.949; P = 0.030). In patients with OCCC, there was no significant effect of adjuvant chemotherapy on OS in any substage. Conclusions Adjuvant chemotherapy was associated with improved OS only in patients with substage IC, grade 3 EEOC. In stage I OCCC, adjuvant chemotherapy was not associated with improved OS.
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Affiliation(s)
- A Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York
| | - M M Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - J Konner
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - R E O'Cearbhaill
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - D Zamarin
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - Y Sonoda
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - G J Gardner
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - K Long Roche
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - C A Aghajanian
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - R N Grisham
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - C L Brown
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - A Snyder
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Department of Medicine, Weill Cornell Medical College, New York
| | - D S Chi
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - R A Soslow
- Gynecologic Pathology, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - N R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
| | - O Zivanovic
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York.,Department of OB/GYN, Weill Cornell Medical College, New York
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17
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Zamarin D, Ricca JM, Sadekova S, Oseledchyk A, Yu Y, Blumenschein WM, Wong J, Gigoux M, Merghoub T, Wolchok JD. PD-L1 in tumor microenvironment mediates resistance to oncolytic immunotherapy. J Clin Invest 2018; 128:1413-1428. [PMID: 29504948 DOI: 10.1172/jci98047] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/28/2017] [Indexed: 12/11/2022] Open
Abstract
Intralesional therapy with oncolytic viruses (OVs) leads to the activation of local and systemic immune pathways, which may present targets for further combinatorial therapies. Here, we used human tumor histocultures as well as syngeneic tumor models treated with Newcastle disease virus (NDV) to identify a range of immune targets upregulated with OV treatment. Despite tumor infiltration of effector T lymphocytes in response to NDV, there was ongoing inhibition through programmed death ligand 1 (PD-L1), acting as a mechanism of early and late adaptive immune resistance to the type I IFN response and T cell infiltration, respectively. Systemic therapeutic targeting of programmed cell death receptor 1 (PD-1) or PD-L1 in combination with intratumoral NDV resulted in the rejection of both treated and distant tumors. These findings have implications for the timing of PD-1/PD-L1 blockade in conjunction with OV therapy and highlight the importance of understanding the adaptive mechanisms of immune resistance to specific OVs for the rational design of combinatorial approaches using these agents.
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Affiliation(s)
- Dmitriy Zamarin
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, New York, USA.,Weill Cornell Medical College, New York, New York, USA.,Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and.,Parker Institute for Cancer Immunotherapy, MSKCC, New York, New York, USA
| | - Jacob M Ricca
- Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and
| | | | - Anton Oseledchyk
- Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and
| | - Ying Yu
- Merck Research Labs (MRL), Palo Alto, California, USA
| | | | - Jerelyn Wong
- Merck Research Labs (MRL), Palo Alto, California, USA
| | - Mathieu Gigoux
- Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and
| | - Taha Merghoub
- Weill Cornell Medical College, New York, New York, USA.,Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and.,Parker Institute for Cancer Immunotherapy, MSKCC, New York, New York, USA
| | - Jedd D Wolchok
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, New York, USA.,Weill Cornell Medical College, New York, New York, USA.,Ludwig Collaborative Laboratory.,Swim Across America Laboratory, and.,Parker Institute for Cancer Immunotherapy, MSKCC, New York, New York, USA
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18
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Ricca JM, Oseledchyk A, Walther T, Liu C, Mangarin L, Merghoub T, Wolchok JD, Zamarin D. Pre-existing Immunity to Oncolytic Virus Potentiates Its Immunotherapeutic Efficacy. Mol Ther 2018; 26:1008-1019. [PMID: 29478729 PMCID: PMC6079372 DOI: 10.1016/j.ymthe.2018.01.019] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/18/2018] [Accepted: 01/25/2018] [Indexed: 12/28/2022] Open
Abstract
Anti-viral immunity presents a major hurdle for systemically administered oncolytic viruses (OV). Intratumoral OV therapy has a potential to overcome this problem through activation of anti-tumor immune response, with local and abscopal effects. However, the effects of anti-viral immunity in such a setting are still not well defined. Using Newcastle Disease Virus (NDV) as a model, we explore the effects of pre-existing anti-viral immunity on therapeutic efficacy in syngeneic mouse tumor models. Unexpectedly, we find that while pre-existing immunity to NDV limits its replication in tumors, tumor clearance, abscopal anti-tumor immune effects, and survival are not compromised and, on the contrary, are superior in NDV-immunized mice. These findings demonstrate that pre-existing immunity to NDV may increase its therapeutic efficacy through potentiation of systemic anti-tumor immunity, which provides clinical rationale for repeated therapeutic dosing and prompts investigation of such effects with other OVs.
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Affiliation(s)
- Jacob M Ricca
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Tyler Walther
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Cailian Liu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Levi Mangarin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Taha Merghoub
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jedd D Wolchok
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY 10065, USA
| | - Dmitriy Zamarin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Swim Across America-Ludwig Collaborative Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY 10065, USA.
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19
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Abstract
Recently, surface-enhanced Raman scattering (SERS) nanoprobes (NPs) have shown promise in the field of cancer imaging due to their unparalleled signal specificity and high sensitivity. Here we report the development of a DNA aptamer targeted SERS NP. Recently, aptamers are being investigated as a viable alternative to more traditional antibody targeting due to their low immunogenicity and low cost of production. We developed a strategy to functionalize SERS NPs with DNA aptamers, which target Mucin1 (MUC1) in human breast cancer (BC). Thorough in vitro characterization studies demonstrated excellent serum stability and specific binding of the targeted NPs to MUC1. In order to test their in vivo targeting capability, we co-injected MUC1-targeted SERS NPs, and as controls non-targeted and blocked MUC1-targeted SERS NPs in BC xenograft mouse models. A two-tumor mouse model with differential expression of MUC1 (MDA-MB-468 and MDA-MB-453) was used to control for active versus passive targeting in the same animals. The results showed that the targeted SERS NPs home to the tumors via active targeting of MUC1, with low levels of passive targeting. We expect this strategy to be an advantageous alternative to antibody-based targeting and useful for targeted imaging of tumor extent, progression, and therapeutic response.
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Affiliation(s)
- Suchetan Pal
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Stefan Harmsen
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Hsiao-Ting Hsu
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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20
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Abstract
Recently, surface-enhanced Raman scattering (SERS) nanoprobes (NPs) have shown promise in the field of cancer imaging due to their unparalleled signal specificity and high sensitivity. Here we report the development of a DNA aptamer targeted SERS NP. Recently, aptamers are being investigated as a viable alternative to more traditional antibody targeting due to their low immunogenicity and low cost of production. We developed a strategy to functionalize SERS NPs with DNA aptamers, which target Mucin1 (MUC1) in human breast cancer (BC). Thorough in vitro characterization studies demonstrated excellent serum stability and specific binding of the targeted NPs to MUC1. In order to test their in vivo targeting capability, we co-injected MUC1-targeted SERS NPs, and as controls non-targeted and blocked MUC1-targeted SERS NPs in BC xenograft mouse models. A two-tumor mouse model with differential expression of MUC1 (MDA-MB-468 and MDA-MB-453) was used to control for active versus passive targeting in the same animals. The results showed that the targeted SERS NPs home to the tumors via active targeting of MUC1, with low levels of passive targeting. We expect this strategy to be an advantageous alternative to antibody-based targeting and useful for targeted imaging of tumor extent, progression, and therapeutic response.
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Affiliation(s)
- Suchetan Pal
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Stefan Harmsen
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Hsiao-Ting Hsu
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Moritz F Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. Molecular Pharmacology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. Weill Cornell Medical College, Cornell University, New York, NY 10065, USA
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21
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Oseledchyk A, Leitao M, Aghajanian C, O'Cearbhaill R, Chi D, Sonoda Y, Barakat R, Long Roche K, Abu-Rustum N, Zivanovic O. Impact of adjuvant chemotherapy in patients with FIGO stage I endometrioid ovarian carcinoma in the platinum era: A Surveillance, Epidemiology, and End Results cohort study, 2000-2013. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Oseledchyk A, Gemignani M, Dickler MN, Goldfarb SB, Iasonos A, Zhou Q, Carter J, Barakat RR, Abu-Rustum N, Zivanovic O. Surgical ovarian ablation for hormone receptor positive primary breast cancer in premenopausal women. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12536 Background: Ovarian ablation is increasingly used to complement endocrine therapy in select premenopausal women with hormone-receptor positive (HR+) breast cancer (BC). It can be achieved by either medical ovarian suppression (OS) or therapeutic bilateral salpingo-oophorectomy (BSO). We sought to investigate trends of therapeutic BSO in premenopausal patients at our institution. Methods: Premenopausal women with HR+ primary BC diagnosed from 2010-2014 were identified in our prospectively maintained BC database. Patients with confirmed BRCA1/2 mutations were excluded. Distribution of patient and disease characteristics between treatment groups were assessed using univariate logistic regression analyses. Surgical details and complications were extracted from our surgical database. Results: We identified 2,854 eligible patients; 2,113 (74%) received endocrine therapy without ovarian ablation, 246 (9%) received endocrine therapy plus medical OS, 180 (6%) underwent additional BSO, and 315 (11%) did not receive endocrine therapy at the time of analysis. Independent predictors for undergoing ovarian ablation were younger age (OR 0.98; 95%CI, 0.96-0.99; p < 0.001), higher grade (grade 3 vs 1: OR 3.17; 95%CI, 1.70-5.90; grade 2 vs 1: OR 3.13; 95%CI, 1.64-5.95; p < 0.001), lymph node involvement (OR 1.46; 95%CI, 1.19-1.80; p < 0.001), and higher AJCC stage as well as de novo metastatic BC (II vs I: OR = 1.35; 95%CI, 1.03-1.76; III vs I: OR 2.57; 95%CI, 1.86-3.55; IV vs I: OR 19.69; 95%CI, 12.76-30.39; p < 0.001). Among patients who underwent ovarian ablation, patients of younger age (1.04; 95%CI, 1.01-1.07; p = 0.009) and with metastatic BC (stage IV vs I: OR 0.36; 95%CI, 0.20-0.68; p = 0.007) were less likely to undergo BSO than OS. In 180 patients undergoing BSO, five adverse events were noted: two grade 1, two grade 2, and one grade 3 complication. Conclusions: Premenopausal women with HR+ BC with high-risk features or metastatic disease were more likely to undergo ovarian ablation at our institution. Surgical ovarian ablation is a safe alternative, with low complication rates. Understanding patient preferences, side effects, and quality of life implications will help guide personalized treatment decisions.
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Affiliation(s)
| | | | | | | | | | - Qin Zhou
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jeanne Carter
- Memorial Sloan-Kettering Cancer Center, New York, NY
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23
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Oseledchyk A, Andreou C, Wall MA, Kircher MF. Folate-Targeted Surface-Enhanced Resonance Raman Scattering Nanoprobe Ratiometry for Detection of Microscopic Ovarian Cancer. ACS Nano 2017; 11:1488-1497. [PMID: 27992724 PMCID: PMC5502101 DOI: 10.1021/acsnano.6b06796] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Ovarian cancer has a unique pattern of metastatic spread, in that it initially spreads locally within the peritoneal cavity. This is in contrast to most other cancer types, which metastasize early on via the bloodstream to distant sites. This unique behavior opens up an opportunity for local application of both therapeutic and imaging agents. Upon initial diagnosis, 75% of patients already present with diffuse peritoneal spread involving abdominal organs. Complete resection of all tumor implants has been shown to be a major factor for improved survival. Unfortunately, it is currently not possible for surgeons to visualize microscopic implants, impeding their removal and leading to tumor recurrences and poor outcomes in most patients. Thus, there is a great need for new intraoperative imaging techniques that can overcome this hurdle. We devised a method that employs folate receptor (FR)-targeted surface-enhanced resonance Raman scattering (SERRS) nanoparticles (NPs), as folate receptors are typically overexpressed in ovarian cancer. We report a robust ratiometric imaging approach using anti-FR-SERRS-NPs (αFR-NPs) and nontargeted SERRS-NPs (nt-NPs) multiplexing. We term this method "topically applied surface-enhanced resonance Raman ratiometric spectroscopy" (TAS3RS ("tasers") for short). TAS3RS successfully enabled the detection of tumor lesions in a murine model of human ovarian adenocarcinoma regardless of their size or localization. Tumors as small as 370 μm were detected, as confirmed by bioluminescence imaging and histological staining. TAS3RS holds promise for intraoperative detection of microscopic residual tumors and could reduce recurrence rates in ovarian cancer and other diseases with peritoneal spread.
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Affiliation(s)
- Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Matthew A. Wall
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Moritz F. Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Radiology, Weill Cornell Medical College, New York, NY 10065, USA
- Address correspondence to Moritz F. Kircher,
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24
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Nayak TR, Andreou C, Oseledchyk A, Marcus WD, Wong HC, Massagué J, Kircher MF. Tissue factor-specific ultra-bright SERRS nanostars for Raman detection of pulmonary micrometastases. Nanoscale 2017; 9:1110-1119. [PMID: 27991632 PMCID: PMC5438878 DOI: 10.1039/c6nr08217c] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Here we demonstrate a novel application of 'surface enhanced resonance Raman scattering nanoparticles' (SERRS NPs) for imaging breast cancer lung metastases with much higher precision than currently feasible. A breast cancer lung metastasis mouse model was established by intravenous injection of LM2 cells. These mice were intravenously administered SERRS NPs conjugated with ALT-836, an anti-tissue factor (TF) monoclonal antibody, and subjected to Raman imaging to visualize the expression of TF both in vivo and ex vivo. Raman imaging indicated marked uptake of αTF-SERRS-NPs by the lung metastases compared to isotype and blocking controls. Conversely, little uptake of αTF-SERRS-NPs was observed in the lungs of healthy mice. Successful detection and delineation of pulmonary micrometastatic lesions as small as 200 μm, corroborated by histology, immunohistochemistry, and bioluminescence imaging confirmed the suitability of both TF as a target and αTF-SERRS-NPs as an effective contrast agent for imaging breast cancer lung metastases. Further advancements of this technique in the form of Raman endoscopes coupled with ultrabright SERRS NPs developed in this work could lead to minimally invasive detection and resection of lung metastases.
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Affiliation(s)
- Tapas R Nayak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | | | - Hing C Wong
- Altor BioScience Corporation, Miramar, FL 33025, USA
| | - Joan Massagué
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Moritz F Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. and Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA and Department of Radiology, Weill Cornell Medical College, New York, New York 10065, USA
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25
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Andreou C, Neuschmelting V, Tschaharganeh DF, Huang CH, Oseledchyk A, Iacono P, Karabeber H, Colen RR, Mannelli L, Lowe SW, Kircher MF. Imaging of Liver Tumors Using Surface-Enhanced Raman Scattering Nanoparticles. ACS Nano 2016; 10:5015-26. [PMID: 27078225 PMCID: PMC4884645 DOI: 10.1021/acsnano.5b07200] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Complete surgical resection is the ideal first-line treatment for most liver malignancies. This goal would be facilitated by an intraoperative imaging method that enables more precise visualization of tumor margins and detection of otherwise invisible microscopic lesions. To this end, we synthesized silica-encapsulated surface-enhanced Raman scattering (SERS) nanoparticles (NPs) that act as a molecular imaging agent for liver malignancies. We hypothesized that, after intravenous administration, SERS NPs would avidly home to healthy liver tissue but not to intrahepatic malignancies. We tested these SERS NPs in genetically engineered mouse models of hepatocellular carcinoma and histiocytic sarcoma. After intravenous injection, liver tumors in both models were readily identifiable with Raman imaging. In addition, Raman imaging using SERS NPs enabled detection of microscopic lesions in liver and spleen. We compared the performance of SERS NPs to fluorescence imaging using indocyanine green (ICG). We found that SERS NPs delineate tumors more accurately and are less susceptible to photobleaching. Given the known advantages of SERS imaging, namely, high sensitivity and specific spectroscopic detection, these findings hold promise for improved resection of liver cancer.
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Affiliation(s)
- Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | - Volker Neuschmelting
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | | | - Chun-Hao Huang
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer
Center, New York, NY 10065, USA
| | - Anton Oseledchyk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | - Pasquale Iacono
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | - Hazem Karabeber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | - Rivka R. Colen
- Department of Radiology, M.D. Anderson Cancer Center, University of
Texas, Houston, Texas, 77030, USA
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
| | - Scott W. Lowe
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer
Center, New York, NY 10065, USA
- Howard Hughes Medical Institute, New York, NY 10065, USA
| | - Moritz F. Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New
York, NY 10065, USA
- Center for Molecular Imaging and Nanotechnology (CMINT), Memorial
Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Radiology, Weill Cornell Medical College, New York, NY
10065, USA
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26
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Oseledchyk A, Zivanovic O. Intraoperative Hyperthermic Intraperitoneal Chemotherapy in Patients With Advanced Ovarian Cancer. Oncology (Williston Park) 2015; 29:695-701. [PMID: 26384807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ovarian cancer, because it is largely confined to the peritoneal cavity, has a unique tumor biology and metastatic spread pattern. Its metastatic potential comes from detached tumor cells in the peritoneal cavity that re-attach to the mesothelial lining of the peritoneal surface. It is proposed that these micrometastases without neovasculature, as well as floating malignant cells, are drivers of early recurrence, since they can be neither resected nor adequately treated by systemic chemotherapy. This represents the major rationale for local treatment by means of postoperative intraperitoneal (IP) chemotherapy, which is the standard of care in the United States in patients with advanced-stage ovarian cancer who have minimal residual disease following cytoreductive surgery. An alternative loco-regional treatment strategy is the "HIPEC" procedure--hyperthermic IP chemoperfusion that is performed during the operation immediately following completion of gross tumor resection, and which provides improved tissue penetration and distribution of the chemotherapeutics. However, prospective data are limited and an outcomes benefit has yet to be shown. Here we discuss the advantages and pitfalls of HIPEC, as well as current data and ongoing prospective trials.
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27
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Oseledchyk A, Abramian A, Kaiser C, Debald M, Domröse C, Kiefer N, Putensen C, Pantelis D, Kuhn W, Schäfer N, Keyver-Paik MD. Total or Subtotal Colectomy in Patients Undergoing Surgery for Primary or Recurrent Epithelial Ovarian Cancer. Oncol Res Treat 2014; 37:448-54. [DOI: 10.1159/000366249] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/18/2014] [Indexed: 11/19/2022]
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28
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Oseledchyk A, Berg C, Gembruch U, Geipel A. Zerebrale Ventrikulomegalie des Feten im ersten Trimenon. Z Geburtshilfe Neonatol 2012. [DOI: 10.1055/s-0032-1309098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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