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Martino EC, Misso G, Pastina P, Costantini S, Vanni F, Gandolfo C, Botta C, Capone F, Lombardi A, Pirtoli L, Tassone P, Ulivieri C, Tagliaferri P, Cusi MG, Caraglia M, Correale P. Immune-modulating effects of bevacizumab in metastatic non-small-cell lung cancer patients. Cell Death Discov 2016; 2:16025. [PMID: 27752361 PMCID: PMC5045963 DOI: 10.1038/cddiscovery.2016.25] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [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: 02/18/2016] [Accepted: 03/02/2016] [Indexed: 01/24/2023] Open
Abstract
The mPEBev is an anticancer regimen which combines a chemotherapy doublet, based on cisplatin and oral etoposide (mPE), with bevacizumab (mPEBev), a mAb targeting the vasculo-endothelial growth factor (VEGF). In previous studies, this regimen showed powerful anti-angiogenetic effects and significant antitumor activity in metastatic non-small-cell lung cancer (mNSCLC) patients. We also recorded the best benefit in patients exhibiting low-systemic inflammatory profile at baseline. On these bases, we hypothesized that mPEBev antitumor activity could be partially related to bevacizumab-associated immunological effects. For this reason, we performed an immunological monitoring in 59 out of 120 stage IIIb-IV NSCLC patients enrolled in the BEVA2007 phase II trial, who received fractioned cisplatin (30 mg/sqm days 1-3q21) and oral etoposide (50 mg, days 1-15q21) (mPE doublet) ±bevacizumab. In this group of patients, 12 received the mPE doublet alone and 47 the doublet in combination with bevacizumab (5 mg/kg on the day 3q21; mPEBev regimen). Blood cell counts, serum analysis, multiplex cytokine assay and immunocytofluorimetric analysis, performed on baseline and post-treatment on blood samples from these patients, revealed that bevacizumab addition to the doublet decreased levels of pro-angiogenic (VEGF, Angiostatin-1 and Follistatin) and inflammatory cytokines (interferon (IFN)γ, IL4 and IL17), improved in vivo and in vitro cytotoxic T-lymphocytes (CTL) response and promoted dendritic cell activation. These results suggest that the mPEBev regimen improve the micro-environmental conditions for an efficient antigen-specific CTL response, making it a feasible candidate regimen to be assessed in combination with immune-checkpoint inhibitors in NSCLC patients.
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Affiliation(s)
- E C Martino
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - G Misso
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - P Pastina
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | | | - F Vanni
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - C Gandolfo
- Microbiology and Virology Unit, Department of Medical Biotechnology , Siena, Italy
| | - C Botta
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | | | - A Lombardi
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - L Pirtoli
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - P Tassone
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | - C Ulivieri
- Department of Science of Life; University of Siena , Siena, Italy
| | - P Tagliaferri
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | - M G Cusi
- Microbiology and Virology Unit, Department of Medical Biotechnology , Siena, Italy
| | - M Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - P Correale
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
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Botta C, Misso G, Martino EC, Pirtoli L, Cusi MG, Tassone P, Tagliaferri P, Caraglia M, Correale P. The route to solve the interplay between inflammation, angiogenesis and anti-cancer immune response. Cell Death Dis 2016; 7:e2299. [PMID: 27441651 PMCID: PMC4973351 DOI: 10.1038/cddis.2016.211] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C Botta
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - G Misso
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University, Naples, Italy
| | | | - L Pirtoli
- Department of Oncology, Siena, Italy
| | - M G Cusi
- Department of Medical Biotechnology University of Siena, Siena, Italy
| | - P Tassone
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - P Tagliaferri
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - M Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University, Naples, Italy
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