1
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Chin WL, Zemek RM, Tilsed CM, Forrest ARR, Fear VS, Forbes C, Boon L, Bosco A, Guo BB, Millward MJ, Nowak AK, Lake RA, Lesterhuis WJ, Lassmann T. Time-course RNAseq data of murine AB1 mesothelioma and Renca renal cancer following immune checkpoint therapy. Sci Data 2024; 11:448. [PMID: 38702329 PMCID: PMC11068878 DOI: 10.1038/s41597-024-03294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
Time-critical transcriptional events in the immune microenvironment are important for response to immune checkpoint blockade (ICB), yet these events are difficult to characterise and remain incompletely understood. Here, we present whole tumor RNA sequencing data in the context of treatment with ICB in murine models of AB1 mesothelioma and Renca renal cell cancer. We sequenced 144 bulk RNAseq samples from these two cancer types across 4 time points prior and after treatment with ICB. We also performed single-cell sequencing on 12 samples of AB1 and Renca tumors an hour before ICB administration. Our samples were equally distributed between responders and non-responders to treatment. Additionally, we sequenced AB1-HA mesothelioma tumors treated with two sample dissociation protocols to assess the impact of these protocols on the quality transcriptional information in our samples. These datasets provide time-course information to transcriptionally characterize the ICB response and provide detailed information at the single-cell level of the early tumor microenvironment prior to ICB therapy.
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Affiliation(s)
- Wee Loong Chin
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- Medical School, University of Western Australia, Crawley, WA, 6009, Australia
- University of Western Australia, Crawley, WA, 6009, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
- Institute for Respiratory Health, Nedlands, WA, 6009, Australia
| | - Rachael M Zemek
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Telethon Kids Institute, University of Western Australia, West Perth, WA, 6872, Australia
| | - Caitlin M Tilsed
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Alistair R R Forrest
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Nedlands, Perth, WA, 6009, Australia
| | - Vanessa S Fear
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Telethon Kids Institute, University of Western Australia, West Perth, WA, 6872, Australia
| | - Catherine Forbes
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Telethon Kids Institute, University of Western Australia, West Perth, WA, 6872, Australia
| | | | - Anthony Bosco
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Asthma and Airway Disease Research Center, University of Arizona, Tuscon, Arizona, USA
- Department of Immunobiology, The University of Arizona, College of Medicine, Tuscon, Arizona, USA
| | - Belinda B Guo
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Nedlands, Perth, WA, 6009, Australia
| | - Michael J Millward
- Medical School, University of Western Australia, Crawley, WA, 6009, Australia
- University of Western Australia, Crawley, WA, 6009, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- Medical School, University of Western Australia, Crawley, WA, 6009, Australia
- University of Western Australia, Crawley, WA, 6009, Australia
- Institute for Respiratory Health, Nedlands, WA, 6009, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia
- Institute for Respiratory Health, Nedlands, WA, 6009, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, Nedlands, WA, 6009, Australia.
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia.
- Telethon Kids Institute, University of Western Australia, West Perth, WA, 6872, Australia.
| | - Timo Lassmann
- Telethon Kids Institute, University of Western Australia, West Perth, WA, 6872, Australia.
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2
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Kidman J, Zemek RM, Sidhom JW, Correa D, Principe N, Sheikh F, Fear VS, Forbes CA, Chopra A, Boon L, Zaitouny A, de Jong E, Holt RA, Jones M, Millward MJ, Lassmann T, Forrest AR, Nowak AK, Watson M, Lake RA, Lesterhuis WJ, Chee J. Immune checkpoint therapy responders display early clonal expansion of tumor infiltrating lymphocytes. Oncoimmunology 2024; 13:2345859. [PMID: 38686178 PMCID: PMC11057660 DOI: 10.1080/2162402x.2024.2345859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
Immune checkpoint therapy (ICT) causes durable tumour responses in a subgroup of patients, but it is not well known how T cell receptor beta (TCRβ) repertoire dynamics contribute to the therapeutic response. Using murine models that exclude variation in host genetics, environmental factors and tumour mutation burden, limiting variation between animals to naturally diverse TCRβ repertoires, we applied TCRseq, single cell RNAseq and flow cytometry to study TCRβ repertoire dynamics in ICT responders and non-responders. Increased oligoclonal expansion of TCRβ clonotypes was observed in responding tumours. Machine learning identified TCRβ CDR3 signatures unique to each tumour model, and signatures associated with ICT response at various timepoints before or during ICT. Clonally expanded CD8+ T cells in responding tumours post ICT displayed effector T cell gene signatures and phenotype. An early burst of clonal expansion during ICT is associated with response, and we report unique dynamics in TCRβ signatures associated with ICT response.
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MESH Headings
- Animals
- Immune Checkpoint Inhibitors/pharmacology
- Immune Checkpoint Inhibitors/therapeutic use
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
- Mice
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/drug effects
- Lymphocytes, Tumor-Infiltrating/metabolism
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/drug effects
- CD8-Positive T-Lymphocytes/metabolism
- Humans
- Mice, Inbred C57BL
- Female
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Affiliation(s)
- Joel Kidman
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
| | | | | | - Debora Correa
- Complex Systems Group, Department of Mathematics and Statistics, University of Western Australia, Perth, Australia
| | - Nicola Principe
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
| | - Fezaan Sheikh
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
| | | | | | - Abha Chopra
- Medical Genomics Laboratories (IIID), Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, Australia
| | | | - Ayham Zaitouny
- Complex Systems Group, Department of Mathematics and Statistics, University of Western Australia, Perth, Australia
- Department of Mathematical Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Emma de Jong
- Telethon Kids Institute, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | | | - Matt Jones
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | | | | | - Alistair R.R. Forrest
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Mark Watson
- Medical Genomics Laboratories (IIID), Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
| | - W. Joost Lesterhuis
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Perth, Australia
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3
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Fisher SA, Patrick K, Hoang T, Marcq E, Behrouzfar K, Young S, Miller TJ, Robinson BWS, Bueno R, Nowak AK, Lesterhuis WJ, Morahan G, Lake RA. The MexTAg collaborative cross: host genetics affects asbestos related disease latency, but has little influence once tumours develop. Front Toxicol 2024; 6:1373003. [PMID: 38694815 PMCID: PMC11061428 DOI: 10.3389/ftox.2024.1373003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024] Open
Abstract
Objectives: This study combines two innovative mouse models in a major gene discovery project to assess the influence of host genetics on asbestos related disease (ARD). Conventional genetics studies provided evidence that some susceptibility to mesothelioma is genetic. However, the identification of host modifier genes, the roles they may play, and whether they contribute to disease susceptibility remain unknown. Here we report a study designed to rapidly identify genes associated with mesothelioma susceptibility by combining the Collaborative Cross (CC) resource with the well-characterised MexTAg mesothelioma mouse model. Methods: The CC is a powerful mouse resource that harnesses over 90% of common genetic variation in the mouse species, allowing rapid identification of genes mediating complex traits. MexTAg mice rapidly, uniformly, and predictably develop mesothelioma, but only after asbestos exposure. To assess the influence of host genetics on ARD, we crossed 72 genetically distinct CC mouse strains with MexTAg mice and exposed the resulting CC-MexTAg (CCMT) progeny to asbestos and monitored them for traits including overall survival, the time to ARD onset (latency), the time between ARD onset and euthanasia (disease progression) and ascites volume. We identified phenotype-specific modifier genes associated with these traits and we validated the role of human orthologues in asbestos-induced carcinogenesis using human mesothelioma datasets. Results: We generated 72 genetically distinct CCMT strains and exposed their progeny (2,562 in total) to asbestos. Reflecting the genetic diversity of the CC, there was considerable variation in overall survival and disease latency. Surprisingly, however, there was no variation in disease progression, demonstrating that host genetic factors do have a significant influence during disease latency but have a limited role once disease is established. Quantitative trait loci (QTL) affecting ARD survival/latency were identified on chromosomes 6, 12 and X. Of the 97-protein coding candidate modifier genes that spanned these QTL, eight genes (CPED1, ORS1, NDUFA1, HS1BP3, IL13RA1, LSM8, TES and TSPAN12) were found to significantly affect outcome in both CCMT and human mesothelioma datasets. Conclusion: Host genetic factors affect susceptibility to development of asbestos associated disease. However, following mesothelioma establishment, genetic variation in molecular or immunological mechanisms did not affect disease progression. Identification of multiple candidate modifier genes and their human homologues with known associations in other advanced stage or metastatic cancers highlights the complexity of ARD and may provide a pathway to identify novel therapeutic targets.
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Affiliation(s)
- Scott A. Fisher
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
| | - Kimberley Patrick
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
| | - Tracy Hoang
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
| | - Elly Marcq
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
- Lab of Dendritic Cell Biology and Cancer Immunotherapy, VIB Center for Inflammation Research, Brussels, Belgium
- Brussels Center for Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kiarash Behrouzfar
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
| | - Sylvia Young
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | - Timothy J. Miller
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Bruce W. S. Robinson
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Raphael Bueno
- Division of Thoracic Surgery, The Lung Center and the International Mesothelioma Program, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | | | - Grant Morahan
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases (NCARD), Perth, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Perth, WA, Australia
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4
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Tilsed CM, Morales MLO, Zemek RM, Gordon BA, Piggott MJ, Nowak AK, Fisher SA, Lake RA, Lesterhuis WJ. Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner. BMC Cancer 2024; 24:203. [PMID: 38350880 PMCID: PMC10865642 DOI: 10.1186/s12885-024-11915-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Chemotherapy is included in treatment regimens for many solid cancers, but when administered as a single agent it is rarely curative. The addition of immune checkpoint therapy to standard chemotherapy regimens has improved response rates and increased survival in some cancers. However, most patients do not respond to treatment and immune checkpoint therapy can cause severe side effects. Therefore, there is a need for alternative immunomodulatory drugs that enhance chemotherapy. METHODS We used gene expression data from cyclophosphamide (CY) responders and non-responders to identify existing clinically approved drugs that could phenocopy a chemosensitive tumor microenvironment (TME), and tested combination treatments in multiple murine cancer models. RESULTS The vitamin A derivative tretinoin was the top predicted upstream regulator of response to CY. Tretinoin pre-treatment induced an inflammatory, interferon-associated TME, with increased infiltration of CD8 + T cells, sensitizing the tumor to subsequent chemotherapy. However, while combination treatment significantly improved survival and cure rate in a CD4+ and CD8+ T cell dependent manner in AB1-HA murine mesothelioma, this effect was model-selective, and could not be replicated using other cell lines. CONCLUSIONS Despite the promising data in one model, the inability to validate the efficacy of combination treatment in multiple cancer models deprioritizes tretinoin/cyclophosphamide combination therapy for clinical translation.
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Affiliation(s)
- Caitlin M Tilsed
- National Centre for Asbestos Related Diseases, 6009, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, 6009, Crawley, WA, Australia
- Institute for Respiratory Health, 6101, Perth, WA, Australia
| | | | - Rachael M Zemek
- Telethon Kids Institute, University of Western Australia, 6872, West Perth, WA, Australia
| | - Brianna A Gordon
- School of Molecular Sciences, University of Western Australia, 6009, Crawley, WA, Australia
| | - Matthew J Piggott
- School of Molecular Sciences, University of Western Australia, 6009, Crawley, WA, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, 6009, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, 6009, Crawley, WA, Australia
- Institute for Respiratory Health, 6101, Perth, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, 6009, Nedlands, WA, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, 6009, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, 6009, Crawley, WA, Australia
- Institute for Respiratory Health, 6101, Perth, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, 6009, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, 6009, Crawley, WA, Australia
- Institute for Respiratory Health, 6101, Perth, WA, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, 6009, Nedlands, WA, Australia.
- School of Biomedical Sciences, University of Western Australia, 6009, Crawley, WA, Australia.
- Institute for Respiratory Health, 6101, Perth, WA, Australia.
- Telethon Kids Institute, University of Western Australia, 6872, West Perth, WA, Australia.
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5
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Orozco Morales ML, Rinaldi CA, de Jong E, Lansley SM, Lee YCG, Zemek RM, Bosco A, Lake RA, Lesterhuis WJ. Geldanamycin treatment does not result in anti-cancer activity in a preclinical model of orthotopic mesothelioma. PLoS One 2023; 18:e0274364. [PMID: 37146029 PMCID: PMC10162533 DOI: 10.1371/journal.pone.0274364] [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] [Received: 09/11/2022] [Accepted: 03/26/2023] [Indexed: 05/07/2023] Open
Abstract
Mesothelioma is characterised by its aggressive invasive behaviour, affecting the surrounding tissues of the pleura or peritoneum. We compared an invasive pleural model with a non-invasive subcutaneous model of mesothelioma and performed transcriptomic analyses on the tumour samples. Invasive pleural tumours were characterised by a transcriptomic signature enriched for genes associated with MEF2C and MYOCD signaling, muscle differentiation and myogenesis. Further analysis using the CMap and LINCS databases identified geldanamycin as a potential antagonist of this signature, so we evaluated its potential in vitro and in vivo. Nanomolar concentrations of geldanamycin significantly reduced cell growth, invasion, and migration in vitro. However, administration of geldanamycin in vivo did not result in significant anti-cancer activity. Our findings show that myogenesis and muscle differentiation pathways are upregulated in pleural mesothelioma which may be related to the invasive behaviour. However, geldanamycin as a single agent does not appear to be a viable treatment for mesothelioma.
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Affiliation(s)
- M Lizeth Orozco Morales
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
- Institute for Respiratory Health, Nedlands, Western Australia, Australia
| | - Catherine A Rinaldi
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
- Centre for Microscopy Characterisation and Analysis, Nedlands, Western Australia, Australia
| | - Emma de Jong
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Sally M Lansley
- Institute for Respiratory Health, Nedlands, Western Australia, Australia
| | - Y C Gary Lee
- Institute for Respiratory Health, Nedlands, Western Australia, Australia
| | - Rachael M Zemek
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Anthony Bosco
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Richard A Lake
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
- Institute for Respiratory Health, Nedlands, Western Australia, Australia
| | - W Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
- Institute for Respiratory Health, Nedlands, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
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6
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Zemek RM, Chin WL, Fear VS, Wylie B, Casey TH, Forbes C, Tilsed CM, Boon L, Guo BB, Bosco A, Forrest ARR, Millward MJ, Nowak AK, Lake RA, Lassmann T, Joost Lesterhuis W. Temporally restricted activation of IFNβ signaling underlies response to immune checkpoint therapy in mice. Nat Commun 2022; 13:4895. [PMID: 35986006 PMCID: PMC9390963 DOI: 10.1038/s41467-022-32567-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/06/2022] [Indexed: 02/08/2023] Open
Abstract
The biological determinants of the response to immune checkpoint blockade (ICB) in cancer remain incompletely understood. Little is known about dynamic biological events that underpin therapeutic efficacy due to the inability to frequently sample tumours in patients. Here, we map the transcriptional profiles of 144 responding and non-responding tumours within two mouse models at four time points during ICB. We find that responding tumours display on/fast-off kinetics of type-I-interferon (IFN) signaling. Phenocopying of this kinetics using time-dependent sequential dosing of recombinant IFNs and neutralizing antibodies markedly improves ICB efficacy, but only when IFNβ is targeted, not IFNα. We identify Ly6C+/CD11b+ inflammatory monocytes as the primary source of IFNβ and find that active type-I-IFN signaling in tumour-infiltrating inflammatory monocytes is associated with T cell expansion in patients treated with ICB. Together, our results suggest that on/fast-off modulation of IFNβ signaling is critical to the therapeutic response to ICB, which can be exploited to drive clinical outcomes towards response. Immune checkpoint blockade (ICB) is partially successful as a cancer therapy. Here using mouse models, the authors transcriptionally monitor responding and non-responding tumours showing that responding tumours were associated with transient IFN-β signalling which could promote the anti-tumour response.
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7
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Tilsed CM, Fisher SA, Nowak AK, Lake RA, Lesterhuis WJ. Cancer chemotherapy: insights into cellular and tumor microenvironmental mechanisms of action. Front Oncol 2022; 12:960317. [PMID: 35965519 PMCID: PMC9372369 DOI: 10.3389/fonc.2022.960317] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/01/2022] [Indexed: 12/12/2022] Open
Abstract
Chemotherapy has historically been the mainstay of cancer treatment, but our understanding of what drives a successful therapeutic response remains limited. The diverse response of cancer patients to chemotherapy has been attributed principally to differences in the proliferation rate of the tumor cells, but there is actually very little experimental data supporting this hypothesis. Instead, other mechanisms at the cellular level and the composition of the tumor microenvironment appear to drive chemotherapy sensitivity. In particular, the immune system is a critical determinant of chemotherapy response with the depletion or knock-out of key immune cell populations or immunological mediators completely abrogating the benefits of chemotherapy in pre-clinical models. In this perspective, we review the literature regarding the known mechanisms of action of cytotoxic chemotherapy agents and the determinants of response to chemotherapy from the level of individual cells to the composition of the tumor microenvironment. We then summarize current work toward the development of dynamic biomarkers for response and propose a model for a chemotherapy sensitive tumor microenvironment.
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Affiliation(s)
- Caitlin M. Tilsed
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Scott A. Fisher
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - W. Joost Lesterhuis
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, University of Western Australia, West Perth, WA, Australia
- *Correspondence: W. Joost Lesterhuis,
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8
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Principe N, Aston WJ, Hope DE, Tilsed CM, Fisher SA, Boon L, Dick IM, Chin WL, McDonnell AM, Nowak AK, Lake RA, Chee J, Lesterhuis WJ. Comprehensive Testing of Chemotherapy and Immune Checkpoint Blockade in Preclinical Cancer Models Identifies Additive Combinations. Front Immunol 2022; 13:872295. [PMID: 35634282 PMCID: PMC9132586 DOI: 10.3389/fimmu.2022.872295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Antibodies that target immune checkpoints such as cytotoxic T lymphocyte antigen 4 (CTLA‐4) and the programmed cell death protein 1/ligand 1 (PD-1/PD-L1) are now a treatment option for multiple cancer types. However, as a monotherapy, objective responses only occur in a minority of patients. Chemotherapy is widely used in combination with immune checkpoint blockade (ICB). Although a variety of isolated immunostimulatory effects have been reported for several classes of chemotherapeutics, it is unclear which chemotherapeutics provide the most benefit when combined with ICB. We investigated 10 chemotherapies from the main canonical classes dosed at the clinically relevant maximum tolerated dose in combination with anti‐CTLA-4/anti-PD-L1 ICB. We screened these chemo-immunotherapy combinations in two murine mesothelioma models from two different genetic backgrounds, and identified chemotherapies that produced additive, neutral or antagonistic effects when combined with ICB. Using flow cytometry and bulk RNAseq, we characterized the tumor immune milieu in additive chemo-immunotherapy combinations. 5-fluorouracil (5-FU) or cisplatin were additive when combined with ICB while vinorelbine and etoposide provided no additional benefit when combined with ICB. The combination of 5-FU with ICB augmented an inflammatory tumor microenvironment with markedly increased CD8+ T cell activation and upregulation of IFNγ, TNFα and IL-1β signaling. The effective anti‐tumor immune response of 5-FU chemo-immunotherapy was dependent on CD8+ T cells but was unaffected when TNFα or IL-1β cytokine signaling pathways were blocked. Our study identified additive and non-additive chemotherapy/ICB combinations and suggests a possible role for increased inflammation in the tumor microenvironment as a basis for effective combination therapy.
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Affiliation(s)
- Nicola Principe
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Wayne J Aston
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia
| | - Danika E Hope
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia
| | - Caitlin M Tilsed
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | | | - Ian M Dick
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Wee Loong Chin
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia
| | | | - Anna K Nowak
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Willem Joost Lesterhuis
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
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9
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Tilsed CM, Casey TH, de Jong E, Bosco A, Zemek RM, Salmons J, Wan G, Millward MJ, Nowak AK, Lake RA, Lesterhuis WJ. Retinoic Acid Induces an IFN-Driven Inflammatory Tumour Microenvironment, Sensitizing to Immune Checkpoint Therapy. Front Oncol 2022; 12:849793. [PMID: 35402250 PMCID: PMC8988133 DOI: 10.3389/fonc.2022.849793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/28/2022] [Indexed: 12/21/2022] Open
Abstract
With immune checkpoint therapy (ICT) having reshaped the treatment of many cancers, the next frontier is to identify and develop novel combination therapies to improve efficacy. Previously, we and others identified beneficial immunological effects of the vitamin A derivative tretinoin on anti-tumour immunity. Although it is known that tretinoin preferentially depletes myeloid derived suppressor cells in blood, little is known about the effects of tretinoin on the tumour microenvironment, hampering the rational design of clinical trials using tretinoin in combination with ICT. Here, we aimed to identify how tretinoin changed the tumour microenvironment in mouse tumour models, using flow cytometry and RNAseq, and we sought to use that information to establish optimal dosing and scheduling of tretinoin in combination with several ICT antibodies in multiple cancer models. We found that tretinoin rapidly induced an interferon dominated inflammatory tumour microenvironment, characterised by increased CD8+ T cell infiltration. This phenotype completely overlapped with the phenotype that was induced by ICT itself, and we confirmed that the combination further amplified this inflammatory milieu. The addition of tretinoin significantly improved the efficacy of anti-CTLA4/anti-PD-L1 combination therapy, and staggered scheduling was more efficacious than concomitant scheduling, in a dose-dependent manner. The positive effects of tretinoin could be extended to ICT antibodies targeting OX40, GITR and CTLA4 monotherapy in multiple cancer models. These data show that tretinoin induces an interferon driven, CD8+ T cell tumour microenvironment that is responsive to ICT.
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Affiliation(s)
- Caitlin M. Tilsed
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
| | - Thomas H. Casey
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
| | - Emma de Jong
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Rachael M. Zemek
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Joanne Salmons
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
| | - Graeme Wan
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
| | - Michael J. Millward
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Richard A. Lake
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
| | - Willem Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, WA, Australia
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
- *Correspondence: Willem Joost Lesterhuis,
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10
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Orozco Morales ML, Rinaldi CA, de Jong E, Lansley SM, Gummer JP, Olasz B, Nambiar S, Hope DE, Casey TH, Lee YCG, Leslie C, Nealon G, Shackleford DM, Powell AK, Grimaldi M, Balaguer P, Zemek RM, Bosco A, Piggott MJ, Vrielink A, Lake RA, Lesterhuis WJ. PPARα and PPARγ activation is associated with pleural mesothelioma invasion but therapeutic inhibition is ineffective. iScience 2022; 25:103571. [PMID: 34984327 PMCID: PMC8692993 DOI: 10.1016/j.isci.2021.103571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/16/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
Mesothelioma is a cancer that typically originates in the pleura of the lungs. It rapidly invades the surrounding tissues, causing pain and shortness of breath. We compared cell lines injected either subcutaneously or intrapleurally and found that only the latter resulted in invasive and rapid growth. Pleural tumors displayed a transcriptional signature consistent with increased activity of nuclear receptors PPARα and PPARγ and with an increased abundance of endogenous PPAR-activating ligands. We found that chemical probe GW6471 is a potent, dual PPARα/γ antagonist with anti-invasive and anti-proliferative activity in vitro. However, administration of GW6471 at doses that provided sustained plasma exposure levels sufficient for inhibition of PPARα/γ transcriptional activity did not result in significant anti-mesothelioma activity in mice. Lastly, we demonstrate that the in vitro anti-tumor effect of GW6471 is off-target. We conclude that dual PPARα/γ antagonism alone is not a viable treatment modality for mesothelioma.
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Affiliation(s)
- M. Lizeth Orozco Morales
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
| | - Catherine A. Rinaldi
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
- Centre for Microscopy Characterisation and Analysis, Nedlands, WA 6009, Australia
| | - Emma de Jong
- Telethon Kids Institute, University of Western Australia, West Perth, WA 6872, Australia
| | | | - Joel P.A. Gummer
- School of Science, Department of Science, Edith Cowan University, Joondalup, WA 6027, Australia
- UWA Medical School, The University of Western Australia, Crawley, WA 6009, Australia
| | - Bence Olasz
- School of Molecular Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Shabarinath Nambiar
- School of Veterinary and Life Science, Murdoch University, Murdoch, WA 6150, Australia
| | - Danika E. Hope
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
| | - Thomas H. Casey
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
| | - Y. C. Gary Lee
- Institute for Respiratory Health, Nedlands, WA 6009, Australia
| | - Connull Leslie
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA 6009, Australia
| | - Gareth Nealon
- School of Molecular Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - David M. Shackleford
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Andrew K. Powell
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Marina Grimaldi
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier 34090, France
| | - Patrick Balaguer
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier 34090, France
| | - Rachael M. Zemek
- Telethon Kids Institute, University of Western Australia, West Perth, WA 6872, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, West Perth, WA 6872, Australia
| | - Matthew J. Piggott
- School of Molecular Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Alice Vrielink
- School of Molecular Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Richard A. Lake
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
| | - W. Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia
- National Centre for Asbestos Related Diseases, Nedlands, WA 6009, Australia
- Telethon Kids Institute, University of Western Australia, West Perth, WA 6872, Australia
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11
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Behrouzfar K, Burton K, Mutsaers SE, Morahan G, Lake RA, Fisher SA. How to Better Understand the Influence of Host Genetics on Developing an Effective Immune Response to Thoracic Cancers. Front Oncol 2021; 11:679609. [PMID: 34235080 PMCID: PMC8256168 DOI: 10.3389/fonc.2021.679609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/31/2021] [Indexed: 01/02/2023] Open
Abstract
Thoracic cancers pose a significant global health burden. Immune checkpoint blockade therapies have improved treatment outcomes, but durable responses remain limited. Understanding how the host immune system interacts with a developing tumor is essential for the rational development of improved treatments for thoracic malignancies. Recent technical advances have improved our understanding of the mutational burden of cancer cells and changes in cancer-specific gene expression, providing a detailed understanding of the complex biology underpinning tumor-host interactions. While there has been much focus on the genetic alterations associated with cancer cells and how they may impact treatment outcomes, how host genetics affects cancer development is also critical and will greatly determine treatment response. Genome-wide association studies (GWAS) have identified genetic variants associated with cancer predisposition. This approach has successfully identified host genetic risk factors associated with common thoracic cancers like lung cancer, but is less effective for rare cancers like malignant mesothelioma. To assess how host genetics impacts rare thoracic cancers, we used the Collaborative Cross (CC); a powerful murine genetic resource designed to maximize genetic diversity and rapidly identify genes associated with any biological trait. We are using the CC in conjunction with our asbestos-induced MexTAg mouse model, to identify host genes associated with mesothelioma development. Once genes that moderate tumor development and progression are known, human homologues can be identified and human datasets interrogated to validate their association with disease outcome. Furthermore, our CC-MexTAg animal model enables in-depth study of the tumor microenvironment, allowing the correlation of immune cell infiltration and gene expression signatures with disease development. This strategy provides a detailed picture of the underlying biological pathways associated with mesothelioma susceptibility and progression; knowledge that is crucial for the rational development of new diagnostic and therapeutic strategies. Here we discuss the influence of host genetics on developing an effective immune response to thoracic cancers. We highlight current knowledge gaps, and with a focus on mesothelioma, describe the development and application of the CC-MexTAg to overcome limitations and illustrate how the knowledge gained from this unique study will inform the rational design of future treatments of mesothelioma.
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Affiliation(s)
- Kiarash Behrouzfar
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Kimberley Burton
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Steve E. Mutsaers
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia
| | - Grant Morahan
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
| | - Scott A. Fisher
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
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12
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Principe N, Kidman J, Lake RA, Lesterhuis WJ, Nowak AK, McDonnell AM, Chee J. Malignant Pleural Effusions-A Window Into Local Anti-Tumor T Cell Immunity? Front Oncol 2021; 11:672747. [PMID: 33987104 PMCID: PMC8111299 DOI: 10.3389/fonc.2021.672747] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/07/2021] [Indexed: 01/01/2023] Open
Abstract
The success of immunotherapy that targets inhibitory T cell receptors for the treatment of multiple cancers has seen the anti-tumor immune response re-emerge as a promising biomarker of response to therapy. Longitudinal characterization of T cells in the tumor microenvironment (TME) helps us understand how to promote effective anti-tumor immunity. However, serial analyses at the tumor site are rarely feasible in clinical practice. Malignant pleural effusions (MPE) associated with thoracic cancers are an abnormal accumulation of fluid in the pleural space that is routinely drained for patient symptom control. This fluid contains tumor cells and immune cells, including lymphocytes, macrophages and dendritic cells, providing a window into the local tumor microenvironment. Recurrent MPE is common, and provides an opportunity for longitudinal analysis of the tumor site in a clinical setting. Here, we review the phenotype of MPE-derived T cells, comparing them to tumor and blood T cells. We discuss the benefits and limitations of their use as potential dynamic biomarkers of response to therapy.
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Affiliation(s)
- Nicola Principe
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Joel Kidman
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Willem Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Medicine, University of Western Australia, Crawley, WA, Australia
| | | | - Jonathan Chee
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
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13
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Cook AM, McDonnell A, Millward MJ, Creaney J, Hasani A, McMullen M, Meniawy T, Robinson BWS, Lake RA, Nowak AK. A phase 1b clinical trial optimizing regulatory T cell depletion in combination with platinum-based chemotherapy in thoracic cancers. Expert Rev Anticancer Ther 2021; 21:465-474. [PMID: 33509005 DOI: 10.1080/14737140.2021.1882308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Single-agent cyclophosphamide can deplete regulatory T-cells (Treg). We aimed to determine optimal dosing and scheduling of oral cyclophosphamide, alongside pemetrexed-based chemotherapy, to deplete Treg in mesothelioma or non-small-cell lung cancer patients.Methods: 31 Patients received pemetrexed ± cisplatin or carboplatin on day 1 of a 21-day cycle (maximum 6 cycles). From cycle two, patients received cyclophosphamide, 50 mg/day, with intrapatient escalation to maximum 100/150 mg/day alternately. Immunological changes were examined by flow cytometry. Primary endpoint was Treg proportion of CD4+ T-cells, with doses tailored to target Treg nadir <4%.Results: Reduction in Treg proportion was observed on day 8 of all cycles, and was not augmented by cyclophosphamide. Few patients achieved the <4% Treg target. Treg proliferation reached nadir one week after chemotherapy, and peaked on day 1 of the subsequent cycle. Efficacy parameters were similar to chemotherapy alone. Seventeen percent of patients ceased cyclophosphamide due to toxicity.Conclusions: Specific Treg depletion to the degree seen with single-agent cyclophosphamide was not observed during pemetrexed-based chemotherapy. This study highlights the poor evidence basis for use of cyclophosphamide as an immunotherapeutic in combination with chemotherapy, and the importance of detailed flow cytometry studies.Trial registration: Clinical trial registration: www.anzctr.org.au identifier is ACTRN12609000260224.
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Affiliation(s)
- Alistair M Cook
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Alison McDonnell
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Michael J Millward
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Jenette Creaney
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Arman Hasani
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Michelle McMullen
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Tarek Meniawy
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Bruce W S Robinson
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Richard A Lake
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Anna K Nowak
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.,Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
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14
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Principe N, Kidman J, Goh S, Tilsed CM, Fisher SA, Fear VS, Forbes CA, Zemek RM, Chopra A, Watson M, Dick IM, Boon L, Holt RA, Lake RA, Nowak AK, Lesterhuis WJ, McDonnell AM, Chee J. Tumor Infiltrating Effector Memory Antigen-Specific CD8 + T Cells Predict Response to Immune Checkpoint Therapy. Front Immunol 2020; 11:584423. [PMID: 33262762 PMCID: PMC7688517 DOI: 10.3389/fimmu.2020.584423] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022] Open
Abstract
Immune checkpoint therapy (ICT) results in durable responses in individuals with some cancers, but not all patients respond to treatment. ICT improves CD8+ cytotoxic T lymphocyte (CTL) function, but changes in tumor antigen-specific CTLs post-ICT that correlate with successful responses have not been well characterized. Here, we studied murine tumor models with dichotomous responses to ICT. We tracked tumor antigen-specific CTL frequencies and phenotype before and after ICT in responding and non-responding animals. Tumor antigen-specific CTLs increased within tumor and draining lymph nodes after ICT, and exhibited an effector memory-like phenotype, expressing IL-7R (CD127), KLRG1, T-bet, and granzyme B. Responding tumors exhibited higher infiltration of effector memory tumor antigen-specific CTLs, but lower frequencies of regulatory T cells compared to non-responders. Tumor antigen-specific CTLs persisted in responding animals and formed memory responses against tumor antigens. Our results suggest that increased effector memory tumor antigen-specific CTLs, in the presence of reduced immunosuppression within tumors is part of a successful ICT response. Temporal and nuanced analysis of T cell subsets provides a potential new source of immune based biomarkers for response to ICT.
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Affiliation(s)
- Nicola Principe
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Joel Kidman
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Siting Goh
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia
| | - Caitlin M Tilsed
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | | | | | | | - Abha Chopra
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Mark Watson
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Ian M Dick
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Louis Boon
- Polpharma Biologics, Utrecht, Netherlands
| | | | - Richard A Lake
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Medicine, University of Western Australia, Crawley, WA, Australia
| | - Willem Joost Lesterhuis
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Alison M McDonnell
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
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15
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Kidman J, Principe N, Watson M, Lassmann T, Holt RA, Nowak AK, Lesterhuis WJ, Lake RA, Chee J. Characteristics of TCR Repertoire Associated With Successful Immune Checkpoint Therapy Responses. Front Immunol 2020; 11:587014. [PMID: 33163002 PMCID: PMC7591700 DOI: 10.3389/fimmu.2020.587014] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [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: 07/24/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022] Open
Abstract
Immunotherapies have revolutionized cancer treatment. In particular, immune checkpoint therapy (ICT) leads to durable responses in some patients with some cancers. However, the majority of treated patients do not respond. Understanding immune mechanisms that underlie responsiveness to ICT will help identify predictive biomarkers of response and develop treatments to convert non-responding patients to responding ones. ICT primarily acts at the level of adaptive immunity. The specificity of adaptive immune cells, such as T and B cells, is determined by antigen-specific receptors. T cell repertoires can be comprehensively profiled by high-throughput sequencing at the bulk and single-cell level. T cell receptor (TCR) sequencing allows for sensitive tracking of dynamic changes in antigen-specific T cells at the clonal level, giving unprecedented insight into the mechanisms by which ICT alters T cell responses. Here, we review how the repertoire influences response to ICT and conversely how ICT affects repertoire diversity. We will also explore how changes to the repertoire in different anatomical locations can better correlate and perhaps predict treatment outcome. We discuss the advantages and limitations of current metrics used to characterize and represent TCR repertoire diversity. Discovery of predictive biomarkers could lie in novel analysis approaches, such as network analysis of amino acids similarities between TCR sequences. Single-cell sequencing is a breakthrough technology that can link phenotype with specificity, identifying T cell clones that are crucial for successful ICT. The field of immuno-sequencing is rapidly developing and cross-disciplinary efforts are required to maximize the analysis, application, and validation of sequencing data. Unravelling the dynamic behavior of the TCR repertoire during ICT will be highly valuable for tracking and understanding anti-tumor immunity, biomarker discovery, and ultimately for the development of novel strategies to improve patient outcomes.
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Affiliation(s)
- Joel Kidman
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Nicola Principe
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Mark Watson
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | | | - Robert A Holt
- Canada's Michael Smith Genome Sciences Centre, Vancouver, BC, Canada
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Willem Joost Lesterhuis
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases, Institute of Respiratory Health, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
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16
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Fisher SA, Peddle-McIntyre CJ, Burton K, Newton RU, Marcq E, Lake RA, Nowak AK. Voluntary exercise in mesothelioma: effects on tumour growth and treatment response in a murine model. BMC Res Notes 2020; 13:435. [PMID: 32933580 PMCID: PMC7493394 DOI: 10.1186/s13104-020-05284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022] Open
Abstract
Objective There is substantial evidence that exercise can safely reduce the risk of cancer and improve survival in different human cancer populations. Long latency periods associated with carcinogen–induced cancers like asbestos induced mesothelioma provide an opportunity to implement exercise as an intervention to delay or prevent disease development. However, there are limited studies investigating the ability of exercise to prevent or delay cancer, and exercise as a preventive strategy has never been assessed in models with a known carcinogen. We investigated the potential of voluntary exercise (VE) to delay development of asbestos related disease (ARD) in our well-characterised, asbestos induced MexTAg model of mesothelioma. Results Asbestos exposed MexTAg mice were given continuous or delayed access to VE and ARD assessed over time. We found that the addition of VE did not affect ARD development in asbestos exposed MexTAg mice. However, non–asbestos exposed, aged matched control mice participated in significantly more VE behaviours, suggesting subclinical development of ARD after asbestos exposure had a greater impact on VE participation than age alone. These data highlight the importance of model choice and the potential limitation that some pre–clinical studies may not accurately represent the clinical paradigm, particularly in the context of prevention studies.
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Affiliation(s)
- Scott A Fisher
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia. .,School of Biomedical Sciences, University of Western Australia, Perth, Australia.
| | - Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Kimberley Burton
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Elly Marcq
- Centre for Oncological Research, University of Antwerp, Antwerp, Belgium
| | - Richard A Lake
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases (NCARD), Perth, Australia.,School of Medicine, University of Western Australia, Perth, Australia
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17
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Zemek RM, De Jong E, Chin WL, Schuster IS, Fear VS, Casey TH, Forbes C, Dart SJ, Leslie C, Zaitouny A, Small M, Boon L, Forrest ARR, Muiri DO, Degli-Esposti MA, Millward MJ, Nowak AK, Lassmann T, Bosco A, Lake RA, Lesterhuis WJ. Sensitization to immune checkpoint blockade through activation of a STAT1/NK axis in the tumor microenvironment. Sci Transl Med 2020; 11:11/501/eaav7816. [PMID: 31316010 DOI: 10.1126/scitranslmed.aav7816] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 06/10/2019] [Indexed: 12/15/2022]
Abstract
Cancer immunotherapy using antibodies that target immune checkpoints has delivered outstanding results. However, responses only occur in a subset of patients, and it is not fully understood what biological processes determine an effective outcome. This lack of understanding hinders the development of rational combination treatments. We set out to define the pretreatment microenvironment associated with an effective outcome by using the fact that inbred mouse strains bearing monoclonal cancer cell line-derived tumors respond in a dichotomous manner to immune checkpoint blockade (ICB). We compared the cellular composition and gene expression profiles of responsive and nonresponsive tumors from mice before ICB and validated the findings in cohorts of patients with cancer treated with ICB antibodies. We found that responsive tumors were characterized by an inflammatory gene expression signature consistent with up-regulation of signal transducer and activator of transcription 1 (STAT1) and Toll-like receptor 3 (TLR3) signaling and down-regulation of interleukin-10 (IL-10) signaling. In addition, responsive tumors had more infiltrating-activated natural killer (NK) cells, which were necessary for response. Pretreatment of mice with large established tumors using the STAT1-activating cytokine interferon-γ (IFNγ), the TLR3 ligand poly(I:C), and an anti-IL-10 antibody sensitized tumors to ICB by attracting IFNγ-producing NK cells into the tumor, resulting in increased cure rates. Our results identify a pretreatment tumor microenvironment that predicts response to ICB, which can be therapeutically attained. These data suggest a biomarker-driven approach to patient management to establish whether a patient would benefit from treatment with sensitizing therapeutics before ICB.
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Affiliation(s)
- Rachael M Zemek
- School of Biomedical Sciences, University of Western Australia, M503, Crawley, WA 6009, Australia.,National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Emma De Jong
- Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
| | - Wee Loong Chin
- National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia.,Medical School, University of Western Australia, M503, Crawley, WA 6009, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009, Australia
| | - Iona S Schuster
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.,Centre for Experimental Immunology, Lions Eye Institute, 2 Verdun Street, Nedlands, WA 6009, Australia.,Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, VIC 3800, Australia
| | - Vanessa S Fear
- National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia.,Medical School, University of Western Australia, M503, Crawley, WA 6009, Australia
| | - Thomas H Casey
- School of Biomedical Sciences, University of Western Australia, M503, Crawley, WA 6009, Australia.,National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Cath Forbes
- National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia.,Medical School, University of Western Australia, M503, Crawley, WA 6009, Australia
| | - Sarah J Dart
- School of Biomedical Sciences, University of Western Australia, M503, Crawley, WA 6009, Australia.,National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Connull Leslie
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA 6009, Australia
| | - Ayham Zaitouny
- School of Mathematics and Statistics, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.,CSIRO, Mineral Resources, 26 Dick Perry Ave, Kensington, WA, 6152, Australia
| | - Michael Small
- School of Mathematics and Statistics, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.,CSIRO, Mineral Resources, 26 Dick Perry Ave, Kensington, WA, 6152, Australia
| | - Louis Boon
- Bioceros, Yalelaan 46, Alexander Numan Building, 3584 CM Utrecht, Netherlands
| | - Alistair R R Forrest
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, University of Western Australia, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Daithi O Muiri
- Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, University of Western Australia, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Mariapia A Degli-Esposti
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.,Centre for Experimental Immunology, Lions Eye Institute, 2 Verdun Street, Nedlands, WA 6009, Australia.,Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, VIC 3800, Australia
| | - Michael J Millward
- Medical School, University of Western Australia, M503, Crawley, WA 6009, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia.,Medical School, University of Western Australia, M503, Crawley, WA 6009, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009, Australia
| | - Timo Lassmann
- Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
| | - Richard A Lake
- School of Biomedical Sciences, University of Western Australia, M503, Crawley, WA 6009, Australia.,National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - W Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, M503, Crawley, WA 6009, Australia. .,National Centre for Asbestos Related Diseases, 5th Floor QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia.,Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
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18
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Zemek RM, Fear VS, Forbes C, de Jong E, Casey TH, Boon L, Lassmann T, Bosco A, Millward MJ, Nowak AK, Lake RA, Lesterhuis WJ. Bilateral murine tumor models for characterizing the response to immune checkpoint blockade. Nat Protoc 2020; 15:1628-1648. [PMID: 32238953 DOI: 10.1038/s41596-020-0299-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/16/2020] [Indexed: 02/01/2023]
Abstract
The therapeutic response to immune checkpoint blockade (ICB) is highly variable, not only between different cancers but also between patients with the same cancer type. The biological mechanisms underlying these differences in response are incompletely understood. Identifying correlates in patient tumor samples is challenging because of genetic and environmental variability. Murine studies usually compare different tumor models or treatments, introducing potential confounding variables. This protocol describes bilateral murine tumor models, derived from syngeneic cancer cell lines, that display a symmetrical yet dichotomous response to ICB. These models enable detailed analysis of whole tumors in a highly homogeneous background, combined with knowledge of the therapeutic outcome within a few weeks, and could potentially be used for mechanistic studies using other (immuno-)therapies. We discuss key considerations and describe how to use two cell lines as fully optimized models. We discuss experimental details, including proper inoculation technique to achieve symmetry and one-sided surgical tumor removal, which takes only 5 min per mouse. Furthermore, we outline the preparation of bulk tissue or single-cell suspensions for downstream analyses such as bulk RNA-seq, immunohistochemistry, single-cell RNA-seq and flow cytometry.
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Affiliation(s)
- Rachael M Zemek
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia. .,National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia. .,Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia.
| | - Vanessa S Fear
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia.,National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia.,Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Cath Forbes
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia.,National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia.,Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Emma de Jong
- Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Thomas H Casey
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
| | | | - Timo Lassmann
- Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia
| | - Michael J Millward
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia.,Medical School, University of Western Australia, Crawley, Western Australia, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia.,Medical School, University of Western Australia, Crawley, Western Australia, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard A Lake
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia.,National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia
| | - W Joost Lesterhuis
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia. .,National Centre for Asbestos Related Diseases, Nedlands, Western Australia, Australia. .,Telethon Kids Institute, University of Western Australia, West Perth, Western Australia, Australia.
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19
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Zemek RM, Chin WL, Nowak AK, Millward MJ, Lake RA, Lesterhuis WJ. Sensitizing the Tumor Microenvironment to Immune Checkpoint Therapy. Front Immunol 2020; 11:223. [PMID: 32133005 PMCID: PMC7040078 DOI: 10.3389/fimmu.2020.00223] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/28/2020] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint blockade (ICB) has revolutionized cancer treatment, providing remarkable clinical responses in some patients. However, the majority of patients do not respond. It is therefore crucial both to identify predictive biomarkers of response and to increase the response rates to immune checkpoint therapy. In this review we explore the current literature about the predictive characteristics of the tumor microenvironment and discuss therapeutic approaches that aim to change this toward a milieu that is conducive to response. We propose a personalized biomarker-based adaptive approach to immunotherapy, whereby a sensitizing therapy is tailored to the patient's specific tumor microenvironment, followed by on-treatment verification of a change in the targeted biomarker, followed by immune checkpoint therapy. By incorporating detailed knowledge of the immunological tumor microenvironment, we may be able to sensitize currently non-responsive tumors to respond to immune checkpoint therapy.
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Affiliation(s)
- Rachael M Zemek
- Telethon Kids Institute, University of Western Australia, West Perth, WA, Australia
| | - Wee Loong Chin
- National Centre for Asbestos Related Diseases, Nedlands, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Nedlands, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Michael J Millward
- Medical School, University of Western Australia, Crawley, WA, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
| | - W Joost Lesterhuis
- Telethon Kids Institute, University of Western Australia, West Perth, WA, Australia.,National Centre for Asbestos Related Diseases, Nedlands, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
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20
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Aston WJ, Hope DE, Cook AM, Boon L, Dick I, Nowak AK, Lake RA, Lesterhuis WJ. Dexamethasone differentially depletes tumour and peripheral blood lymphocytes and can impact the efficacy of chemotherapy/checkpoint blockade combination treatment. Oncoimmunology 2019; 8:e1641390. [PMID: 31646089 PMCID: PMC6791454 DOI: 10.1080/2162402x.2019.1641390] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022] Open
Abstract
Dexamethasone is a synthetic glucocorticoid commonly used for the prevention and management of side effects in cancer patients undergoing chemotherapy. While it is effective as an anti-emetic and in preventing hypersensitivity reactions, dexamethasone depletes peripheral blood lymphocytes and impacts immune responses. The effect of dexamethasone on the number and quality of tumour-infiltrating leukocytes has not been reported. To address this, we calibrated the dose in two different strains of mice to achieve the same extent of peripheral blood lymphocyte depletion observed in patients with cancer. Doses that caused analogous depletion of T and B lymphocytes and NK cells from the peripheral blood, elicited no change in these populations within the tumour. The expression of immune checkpoint molecules PD-1, OX40, GITR and TIM3 on tumour-infiltrating lymphocytes was not altered. We found that dexamethasone had a small but significant deleterious impact on weakly efficacious chemoimmunotherapy but had no effect when the protocol was highly efficacious. Based on these results, we predict that dexamethasone will have a modest negative influence on the overall effectiveness of chemoimmunotherapy treatment.
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Affiliation(s)
- Wayne J. Aston
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- Medical School, The University of Western Australia, Nedlands, WA, Australia
| | - Danika E. Hope
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Alistair M. Cook
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- Medical School, The University of Western Australia, Nedlands, WA, Australia
| | | | - Ian Dick
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- Medical School, The University of Western Australia, Nedlands, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - W. Joost Lesterhuis
- National Centre for Asbestos Related Diseases, The University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, The University of Western Australia, Nedlands, WA, Australia
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21
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Chee J, Watson MW, Chopra A, Nguyen B, Cook AM, Creaney J, Lesterhuis WJ, Robinson BW, Lee YCG, Nowak AK, Lake RA, McDonnell AM. Tumour associated lymphocytes in the pleural effusions of patients with mesothelioma express high levels of inhibitory receptors. BMC Res Notes 2018; 11:864. [PMID: 30518402 PMCID: PMC6282254 DOI: 10.1186/s13104-018-3953-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/26/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Pleural effusion (PE) is a common feature of malignant pleural mesothelioma. These effusions typically contain lymphocytes and malignant cells. We postulated that the PE would be a source of lymphocytes for analysis of tumor immune milieu. The aim of this study was to compare the phenotype and T cell receptor usage of pleural effusion T cells with paired concurrently drawn peripheral blood lymphocytes. We used multi-parameter flow cytometry and high-throughput T cell receptor sequencing to analyse peripheral blood and pleural effusion mononuclear cells. RESULTS Both CD8+ and CD4+ T cells from effusion showed increased expression of T cell inhibitory receptors PD-1, LAG-3 and Tim-3 compared to blood. Comprehensive T cell receptor sequencing on one of the patients showed a discordant distribution of clonotypes in the antigen-experienced (PD-1+) compartment between effusion and blood, suggesting an enrichment of antigen specific clonotypes in the effusion, with potential as an immunological response biomarker.
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Affiliation(s)
- Jonathan Chee
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia.
| | - Mark W Watson
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
| | - Abha Chopra
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
| | - Bella Nguyen
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Alistair M Cook
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia
| | - Jenette Creaney
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia
| | - Willem J Lesterhuis
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia
| | - Bruce W Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Y C Gary Lee
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute of Respiratory Health, School of Medicine, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia
| | - Alison M McDonnell
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia
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22
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Fear VS, Tilsed C, Chee J, Forbes CA, Casey T, Solin JN, Lansley SM, Lesterhuis WJ, Dick IM, Nowak AK, Robinson BW, Lake RA, Fisher SA. Combination immune checkpoint blockade as an effective therapy for mesothelioma. Oncoimmunology 2018; 7:e1494111. [PMID: 30288361 DOI: 10.1080/2162402x.2018.1494111] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 12/29/2022] Open
Abstract
Mesothelioma is an aggressive asbestos induced cancer with extremely poor prognosis and limited treatment options. Immune checkpoint blockade (ICPB) has demonstrated effective therapy in melanoma and is now being applied to other cancers, including mesothelioma. However, the efficacy of ICPB and which immune checkpoint combinations constitute the best therapeutic option for mesothelioma have yet to be fully elucidated. Here, we used our well characterised mesothelioma tumour model to investigate the efficacy of different ICBP treatments to generate effective therapy for mesothelioma. We show that tumour resident regulatory T cell co-express high levels of CTLA-4, OX40 and GITR relative to T effector subsets and that these receptors are co-expressed on a large proportion of cells. Targeting any of CTLA-4, OX40 or GITR individually generated effective responses against mesothelioma. Furthermore, the combination of αCTLA-4 and αOX40 was synergistic, with an increase in complete tumour regressions from 20% to 80%. Other combinations did not synergise to enhance treatment outcomes. Finally, an early pattern in T cell response was predictive of response, with activation status and ICP receptor expression profile of T effector cells harvested from tumour and dLN correlating with response to immunotherapy. Taken together, these data demonstrate that combination ICPB can work synergistically to induce strong, durable immunity against mesothelioma in an animal model.
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Affiliation(s)
- Vanessa S Fear
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Caitlin Tilsed
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Catherine A Forbes
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Thomas Casey
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Jessica N Solin
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia
| | - Sally M Lansley
- Centre for Respiratory Health, School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - William Joost Lesterhuis
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Ian M Dick
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Medicine, The University of Western Australia, Perth, Australia
| | - Bruce W Robinson
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Medicine, The University of Western Australia, Perth, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Medicine, The University of Western Australia, Perth, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases (NCARD). Lv5 QQ Block (M503). QEII Medical Centre, The University of Western Australia, Perth, Australia.,School of Biomedical Sciences, The University of Western Australia, Perth, Australia
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23
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Aston WJ, Hope DE, Nowak AK, Robinson BW, Lake RA, Lesterhuis WJ. A systematic investigation of the maximum tolerated dose of cytotoxic chemotherapy with and without supportive care in mice. BMC Cancer 2017; 17:684. [PMID: 29037232 PMCID: PMC5644108 DOI: 10.1186/s12885-017-3677-7] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 10/08/2017] [Indexed: 12/11/2022] Open
Abstract
Background Cytotoxic chemotherapeutics form the cornerstone of systemic treatment of many cancers. Patients are dosed at maximum tolerated dose (MTD), which is carefully determined in phase I studies. In contrast, in murine studies, dosages are often based on customary practice or small pilot studies, which often are not well documented. Consequently, research groups need to replicate experiments, resulting in an excess use of animals and highly variable dosages across the literature. In addition, while patients often receive supportive treatments in order to allow dose escalation, mice do not. These issues could affect experimental results and hence clinical translation. Methods To address this, we determined the single-dose MTD in BALB/c and C57BL/6 mice for a range of chemotherapeutics covering the canonical classes, with clinical score and weight as endpoints. Results We found that there was some variation in MTDs between strains and the tolerability of repeated cycles of chemotherapy at MTD was drug-dependent. We also demonstrate that dexamethasone reduces chemotherapy-induced weight loss in mice. Conclusion These data form a resource for future studies using chemotherapy in mice, increasing comparability between studies, reducing the number of mice needed for dose optimisation experiments and potentially improving translation to the clinic. Electronic supplementary material The online version of this article (10.1186/s12885-017-3677-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wayne J Aston
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Danika E Hope
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Bruce W Robinson
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, University of Western Australia, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia. .,Faculty of Health and Medical Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
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McCoy MJ, Hemmings C, Anyaegbu CC, Austin SJ, Lee-Pullen TF, Miller TJ, Bulsara MK, Zeps N, Nowak AK, Lake RA, Platell CF. Tumour-infiltrating regulatory T cell density before neoadjuvant chemoradiotherapy for rectal cancer does not predict treatment response. Oncotarget 2017; 8:19803-19813. [PMID: 28177891 PMCID: PMC5386723 DOI: 10.18632/oncotarget.15048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/07/2017] [Indexed: 12/21/2022] Open
Abstract
Neoadjuvant (preoperative) chemoradiotherapy (CRT) decreases the risk of rectal cancer recurrence and reduces tumour volume prior to surgery. However, response to CRT varies considerably between individuals and factors associated with response are poorly understood. Foxp3+ regulatory T cells (Tregs) inhibit anti-tumour immunity and may limit any response to chemotherapy and radiotherapy. We have previously reported that a low density of Tregs in the tumour stroma following neoadjuvant CRT for rectal cancer is associated with improved tumour regression. Here we have examined the association between Treg density in pre-treatment diagnostic biopsy specimens and treatment response, in this same patient cohort. We aimed to determine whether pre-treatment tumour-infiltrating Treg density predicts subsequent response to neoadjuvant CRT. Foxp3+, CD8+ and CD3+ cell densities in biopsy samples from 106 patients were assessed by standard immunohistochemistry (IHC) and evaluated for their association with tumour regression grade and survival. We found no association between the density of any T cell subset pre-treatment and clinical outcome, indicating that tumour-infiltrating Treg density does not predict response to neoadjuvant CRT in rectal cancer. Taken together with the findings of the previous study, these data suggest that in the context of neoadjuvant CRT for rectal cancer, the impact of chemotherapy and/or radiotherapy on anti-tumour immunity may be more important than the state of the pre-existing local immune response.
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Affiliation(s)
- Melanie J McCoy
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, 6009, Australia
| | - Chris Hemmings
- Department of Anatomic Pathology, St John of God Pathology, Wembley, WA, 6014, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
| | - Chidozie C Anyaegbu
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia
| | - Stephanie J Austin
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
| | - Tracey F Lee-Pullen
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
| | - Timothy J Miller
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
| | - Max K Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, WA, 6959, Australia
| | - Nikolajs Zeps
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
| | - Anna K Nowak
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, 6009, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Richard A Lake
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, 6009, Australia
| | - Cameron F Platell
- Colorectal Research Unit, St John of God Subiaco Hospital, Subiaco, WA, 6008, Australia.,School of Surgery, University of Western Australia, Crawley, WA, 6009, Australia
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25
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McDonnell AM, Cook A, Robinson BWS, Lake RA, Nowak AK. Serial immunomonitoring of cancer patients receiving combined antagonistic anti-CD40 and chemotherapy reveals consistent and cyclical modulation of T cell and dendritic cell parameters. BMC Cancer 2017; 17:417. [PMID: 28619093 PMCID: PMC5472884 DOI: 10.1186/s12885-017-3403-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 06/06/2017] [Indexed: 11/11/2022] Open
Abstract
Background CD40 signalling can synergise with chemotherapy in preclinical cancer models, and early clinical studies are promising. We set out to define the immunological changes associated with this therapeutic combination to identify biomarkers for a response to the therapy. Here, we present serial immunomonitoring examining dendritic cell and T cell subpopulations over sequential courses of chemoimmunotherapy. Methods Fifteen patients with mesothelioma received up to six 21-day cycles of pemetrexed plus cisplatin chemotherapy and anti-CD40 (CP-870,893). Peripheral blood was collected weekly, and analysed by flow cytometry. Longitudinal immunophenotyping data was analysed by linear mixed modelling, allowing for variation between patients. Exploratory analyses testing for any correlation between overall survival and immunophenotyping data were undertaken up to the third cycle of treatment. Results Large statistically significant cyclical variations in the proportions of BDCA-1+, BDCA-2+ and BDCA-3+ dendritic cells were observed, although all subsets returned to baseline levels after each cycle and no significant changes were observed between start and end of treatment. Expression levels of CD40 and HLA-DR on dendritic cells were also cyclically modulated, again without significant change between start and end of treatment. CD8 and CD4 T cell populations, along with regulatory T cells, effector T cells, and markers of proliferation and activation, showed similar patterns of statistically significant cyclical modulation in response to therapy without changes between start and end of treatment. Exploratory analysis of endpoints revealed that patients with a higher than average proportion of BDCA-2+ dendritic cells (p = 0.010) or a higher than average proportion of activated (ICOS+) CD8 T cells (0.022) in pretreatment blood samples had better overall survival. A higher than average proportion of BDCA-3+ dendritic cells was associated with poorer overall survival at both the second (p = 0.008) and third (p = 0.014) dose of anti-CD40. Conclusions Substantial cyclical variations in DC and T cell populations during sequential cycles of chemoimmunotherapy highlight the critical importance of timing of immunological biomarker assessments in interpretation of results and the value of linear mixed modelling in interpretation of longitudinal change over a full treatment course. Trial registration Australia New Zealand Clinical Trials Registry number ACTRN12609000294257 (18th May 2009).
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Affiliation(s)
- Alison M McDonnell
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, 6009, Australia.,National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Alistair Cook
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, 6009, Australia.,National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Bruce W S Robinson
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, 6009, Australia.,National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley, WA, 6009, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Richard A Lake
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, 6009, Australia.,National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Anna K Nowak
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, 6009, Australia. .,National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley, WA, 6009, Australia. .,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia.
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26
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Fisher SA, Aston WJ, Chee J, Khong A, Cleaver AL, Solin JN, Ma S, Lesterhuis WJ, Dick I, Holt RA, Creaney J, Boon L, Robinson B, Lake RA. Transient Treg depletion enhances therapeutic anti-cancer vaccination. Immun Inflamm Dis 2017; 5:16-28. [PMID: 28250921 PMCID: PMC5322183 DOI: 10.1002/iid3.136] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/18/2016] [Accepted: 09/19/2016] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Regulatory T cells (Treg) play an important role in suppressing anti- immunity and their depletion has been linked to improved outcomes. To better understand the role of Treg in limiting the efficacy of anti-cancer immunity, we used a Diphtheria toxin (DTX) transgenic mouse model to specifically target and deplete Treg. METHODS Tumor bearing BALB/c FoxP3.dtr transgenic mice were subjected to different treatment protocols, with or without Treg depletion and tumor growth and survival monitored. RESULTS DTX specifically depleted Treg in a transient, dose-dependent manner. Treg depletion correlated with delayed tumor growth, increased effector T cell (Teff) activation, and enhanced survival in a range of solid tumors. Tumor regression was dependent on Teffs as depletion of both CD4 and CD8 T cells completely abrogated any survival benefit. Severe morbidity following Treg depletion was only observed, when consecutive doses of DTX were given during peak CD8 T cell activation, demonstrating that Treg can be depleted on multiple occasions, but only when CD8 T cell activation has returned to base line levels. Finally, we show that even minimal Treg depletion is sufficient to significantly improve the efficacy of tumor-peptide vaccination. CONCLUSIONS BALB/c.FoxP3.dtr mice are an ideal model to investigate the full therapeutic potential of Treg depletion to boost anti-tumor immunity. DTX-mediated Treg depletion is transient, dose-dependent, and leads to strong anti-tumor immunity and complete tumor regression at high doses, while enhancing the efficacy of tumor-specific vaccination at low doses. Together this data highlight the importance of Treg manipulation as a useful strategy for enhancing current and future cancer immunotherapies.
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Affiliation(s)
- Scott A. Fisher
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Wayne J. Aston
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Jonathan Chee
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Andrea Khong
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Amanda L. Cleaver
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Jessica N. Solin
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Shaokang Ma
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - W. Joost Lesterhuis
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Ian Dick
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Robert A. Holt
- British Columbia Cancer AgencyVancouverBritish ColumbiaCanada
| | - Jenette Creaney
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | | | - Bruce Robinson
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
| | - Richard A. Lake
- School of Medicine and PharmacologyUniversity of Western Australia, QEII Medical CentreNedlandsWestern AustraliaAustralia
- National Research Centre for Asbestos Related DiseasesQEII Medical CentreNedlandsWestern AustraliaAustralia
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Brims FJ, Meniawy TM, Duffus I, de Fonseka D, Segal A, Creaney J, Maskell N, Lake RA, de Klerk N, Nowak AK. A Novel Clinical Prediction Model for Prognosis in Malignant Pleural Mesothelioma Using Decision Tree Analysis. J Thorac Oncol 2016; 11:573-82. [DOI: 10.1016/j.jtho.2015.12.108] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 10/22/2022]
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Meniawy TM, Lake RA, McDonnell AM, Millward MJ, Nowak AK. PD-L1 on peripheral blood T lymphocytes is prognostic in patients with non-small cell lung cancer (NSCLC) treated with EGFR inhibitors. Lung Cancer 2016; 93:9-16. [DOI: 10.1016/j.lungcan.2015.12.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/20/2015] [Accepted: 12/25/2015] [Indexed: 10/22/2022]
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Cook AM, Lesterhuis WJ, Nowak AK, Lake RA. Chemotherapy and immunotherapy: mapping the road ahead. Curr Opin Immunol 2015; 39:23-9. [PMID: 26724433 DOI: 10.1016/j.coi.2015.12.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 12/17/2022]
Abstract
Cancer immunotherapy, and in particular checkpoint blockade, is now standard clinical care for a growing number of cancers. Cytotoxic drugs have been the primary weapon against cancer for a long time and have typically been understood because of their capacity to directly kill tumour cells. It is now clear that these drugs are potential partners for checkpoint blockade and different drugs can influence the immune response to cancer through a wide variety of mechanisms. Some of these relate to immunogenic cell death, whilst others relate to changes in antigen-presentation, tumour cell targeting, or depletion of immunosuppressive cells. Here, we review some recent advances in our understanding of the immunological changes associated with chemotherapy, discuss progress in combining chemotherapy with checkpoint blockade, and comment on the difficulties encountered in translating promising preclinical data into successful treatments for cancer patients.
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Affiliation(s)
- Alistair M Cook
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
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30
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Robinson C, Dick IM, Wise MJ, Holloway A, Diyagama D, Robinson BWS, Creaney J, Lake RA. Consistent gene expression profiles in MexTAg transgenic mouse and wild type mouse asbestos-induced mesothelioma. BMC Cancer 2015; 15:983. [PMID: 26680231 PMCID: PMC4683914 DOI: 10.1186/s12885-015-1953-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 06/21/2015] [Accepted: 11/23/2015] [Indexed: 02/08/2023] Open
Abstract
Background The MexTAg transgenic mouse model of mesothelioma replicates many aspects of human mesothelioma, including induction by asbestos, pathogenicity and response to cytotoxic chemotherapy, despite high levels of the SV40 large T Antigen (TAg) in the mesothelial compartment. This model enables analysis of the molecular events associated with asbestos induced mesothelioma and is utilised here to investigate the molecular dynamics of tumours induced in these mice, using gene expression patterns as a read out. Methods Gene expression of MexTAg mesothelioma cell lines bearing a high or low number of copies of the TAg transgene were compared to wild type mouse mesotheliomas and normal mouse mesothelial cells using Affymetrix microarray. These data were then compared to a similar published human microarray study using the same platform. Results The main expression differences between transgenic mouse and wild type mouse mesotheliomas occurred for genes involved in cell cycle regulation and DNA replication, as would be expected from overexpression of the TAg oncogene. Quantitative PCR confirmed that E2F and E2F regulated genes were significantly more upregulated in MexTAg mesotheliomas and MexTAg mesothelial cells compared to wild type mesotheliomas. Like human mesothelioma, both MexTAg and wild type mesotheliomas had more genes underexpressed than overexpressed compared to normal mouse mesothelial cells. Most notably, the cdkn2 locus was deleted in the wild type mouse mesotheliomas, consistent with 80 % human mesotheliomas, however, this region was not deleted in MexTAg mesotheliomas. Regardless of the presence of TAg, all mouse mesotheliomas had a highly concordant set of deregulated genes compared to normal mesothelial cells that overlapped with the deregulated genes between human mesotheliomas and mesothelial cells. Conclusions This investigation demonstrates that the MexTAg mesotheliomas are comparable with wild type mouse mesotheliomas in their representation of human mesothelioma at the molecular level, with some key gene expression differences that are attributable to the TAg transgene expression. Of particular note, MexTAg mesothelioma development was not dependent on cdkn2 deletion. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1953-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cleo Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia. .,Anatomical Pathology, PathWest Laboratory Medicine, J Block, QEII Medical Centre, Hospital Ave, Nedlands, Perth, 6009, Western Australia, Australia. .,Present address: Anatomical Pathology, PathWest Laboratory Medicine, J Block, QEII Medical Centre, Hospital Ave, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Ian M Dick
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Michael J Wise
- School of Chemistry and Biochemistry, University of Western Australia, Crawley, Perth, 6008, Western Australia, Australia.
| | - Andrew Holloway
- Peter MacCallum Institute for Cancer Research, St. Andrew's Place, Melbourne, 3002, Victoria, Australia.
| | - Dileepa Diyagama
- Peter MacCallum Institute for Cancer Research, St. Andrew's Place, Melbourne, 3002, Victoria, Australia.
| | - Bruce W S Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Jenette Creaney
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
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McCoy MJ, Hemmings C, Miller TJ, Austin SJ, Bulsara MK, Zeps N, Nowak AK, Lake RA, Platell CF. Low stromal Foxp3+ regulatory T-cell density is associated with complete response to neoadjuvant chemoradiotherapy in rectal cancer. Br J Cancer 2015; 113:1677-86. [PMID: 26645238 PMCID: PMC4702002 DOI: 10.1038/bjc.2015.427] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [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] [Revised: 11/05/2015] [Accepted: 11/12/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Foxp3+ regulatory T cells (Tregs) play a vital role in preventing autoimmunity, but also suppress antitumour immune responses. Tumour infiltration by Tregs has strong prognostic significance in colorectal cancer, and accumulating evidence suggests that chemotherapy and radiotherapy efficacy has an immune-mediated component. Whether Tregs play an inhibitory role in chemoradiotherapy (CRT) response in rectal cancer remains unknown. METHODS Foxp3+, CD3+, CD4+, CD8+ and IL-17+ cell density in post-CRT surgical samples from 128 patients with rectal cancer was assessed by immunohistochemistry. The relationship between T-cell subset densities and clinical outcome (tumour regression and survival) was evaluated. RESULTS Stromal Foxp3+ cell density was strongly associated with tumour regression grade (P=0.0006). A low stromal Foxp3+ cell density was observed in 84% of patients who had a pathologic complete response (pCR) compared with 41% of patients who did not (OR: 7.56, P=0.0005; OR: 5.27, P=0.006 after adjustment for presurgery clinical factors). Low stromal Foxp3+ cell density was also associated with improved recurrence-free survival (HR: 0.46, P=0.03), although not independent of tumour regression grade. CONCLUSIONS Regulatory T cells in the tumour microenvironment may inhibit response to neoadjuvant CRT and may represent a therapeutic target in rectal cancer.
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Affiliation(s)
- M J McCoy
- St John of God Subiaco Hospital, PO Box 14, Subiaco, WA 6904, Australia.,School of Medicine and Pharmacology, University of Western Australia, M503, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - C Hemmings
- St John of God Pathology, PO Box 646, Wembley, WA 6913, Australia.,School of Surgery, University of Western Australia, M507, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - T J Miller
- St John of God Subiaco Hospital, PO Box 14, Subiaco, WA 6904, Australia.,School of Surgery, University of Western Australia, M507, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - S J Austin
- St John of God Subiaco Hospital, PO Box 14, Subiaco, WA 6904, Australia
| | - M K Bulsara
- Institute for Health Research, University of Notre Dame, PO Box 1225, Fremantle, WA 6959, Australia
| | - N Zeps
- St John of God Subiaco Hospital, PO Box 14, Subiaco, WA 6904, Australia.,School of Surgery, University of Western Australia, M507, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - A K Nowak
- School of Medicine and Pharmacology, University of Western Australia, M503, 35 Stirling Highway, Crawley, WA 6009, Australia.,Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia
| | - R A Lake
- School of Medicine and Pharmacology, University of Western Australia, M503, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - C F Platell
- St John of God Subiaco Hospital, PO Box 14, Subiaco, WA 6904, Australia.,School of Surgery, University of Western Australia, M507, 35 Stirling Highway, Crawley, WA 6009, Australia
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32
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Cook AM, Khong A, Nowak AK, Lake RA. Novel insights into the pathophysiology and treatment of malignant pleural mesothelioma. Lung Cancer Manag 2015. [DOI: 10.2217/lmt.15.23] [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: 11/21/2022] Open
Abstract
Malignant pleural mesothelioma is an aggressive, treatment-resistant tumor, which continues to increase in frequency throughout the world because the causative agent, asbestos, has high economic importance, particularly in developing countries. Patients typically present with breathlessness and chest pain with pleural effusions. Median survival is around 12 months from diagnosis. Palliative chemotherapy is beneficial for mesothelioma patients with high performance status. The role of aggressive surgery remains controversial. This review will outline some of the recent advances in the development of novel therapies for malignant pleural mesothelioma, with a focus on immunological approaches.
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Affiliation(s)
- Alistair M Cook
- National Centre for Asbestos Related Diseases & School of Medicine & Pharmacology, University of Western Australia, Crawley WA, Australia
| | - Andrea Khong
- National Centre for Asbestos Related Diseases & School of Medicine & Pharmacology, University of Western Australia, Crawley WA, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases & School of Medicine & Pharmacology, University of Western Australia, Crawley WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases & School of Medicine & Pharmacology, University of Western Australia, Crawley WA, Australia
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33
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Nowak AK, Cook AM, McDonnell AM, Millward MJ, Creaney J, Francis RJ, Hasani A, Segal A, Musk AW, Turlach BA, McCoy MJ, Robinson BWS, Lake RA. A phase 1b clinical trial of the CD40-activating antibody CP-870,893 in combination with cisplatin and pemetrexed in malignant pleural mesothelioma. Ann Oncol 2015; 26:2483-90. [PMID: 26386124 DOI: 10.1093/annonc/mdv387] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [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: 05/15/2015] [Accepted: 09/11/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Data from murine models suggest that CD40 activation may synergize with cytotoxic chemotherapy. We aimed to determine the maximum tolerated dose (MTD) and toxicity profile and to explore immunological biomarkers of the CD40-activating antibody CP-870,893 with cisplatin and pemetrexed in patients with malignant pleural mesothelioma (MPM). PATIENTS AND METHODS Eligible patients had confirmed MPM, ECOG performance status 0-1, and measurable disease. Patients received cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 and CP-870,893 on day 8 of a 21-day cycle for maximum 6 cycles with up to 6 subsequent cycles single-agent CP-870,893. Immune cell subset changes were examined weekly by flow cytometry. RESULTS Fifteen patients were treated at three dose levels. The MTD of CP-870,893 was 0.15 mg/kg, and was exceeded at 0.2 mg/kg with one grade 4 splenic infarction and one grade 3 confusion and hyponatraemia. Cytokine release syndrome (CRS) occurred in most patients (80%) following CP-870,893. Haematological toxicities were consistent with cisplatin and pemetrexed chemotherapy. Six partial responses (40%) and 9 stable disease (53%) as best response were observed. The median overall survival was 16.5 months; the median progression-free survival was 6.3 months. Three patients survived beyond 30 months. CD19+ B cells decreased over 6 cycles of chemoimmunotherapy (P < 0.001) with a concomitant increase in the proportion of CD27+ memory B cells (P < 0.001) and activated CD86+CD27+ memory B cells (P < 0.001), as an immunopharmacodynamic marker of CD40 activation. CONCLUSIONS CP-870,893 with cisplatin and pemetrexed is safe and tolerable at 0.15 mg/kg, although most patients experience CRS. While objective response rates are similar to chemotherapy alone, three patients achieved long-term survival. AUSTRALIA NEW ZEALAND CLINICAL TRIALS REGISTRY NUMBER ACTRN12609000294257.
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Affiliation(s)
- A K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - A M Cook
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - A M McDonnell
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - M J Millward
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth School of Medicine and Pharmacology
| | - J Creaney
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - R J Francis
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth Department of Nuclear Medicine
| | - A Hasani
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth
| | | | - A W Musk
- School of Medicine and Pharmacology Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth School of Population Health
| | - B A Turlach
- Centre for Applied Statistics, University of Western Australia, Perth
| | - M J McCoy
- School of Medicine and Pharmacology St John of God Hospital, Perth, Australia
| | - B W S Robinson
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth
| | - R A Lake
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
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Cook AM, McDonnell AM, Lake RA, Nowak AK. Dexamethasone co-medication in cancer patients undergoing chemotherapy causes substantial immunomodulatory effects with implications for chemo-immunotherapy strategies. Oncoimmunology 2015; 5:e1066062. [PMID: 27141331 PMCID: PMC4839331 DOI: 10.1080/2162402x.2015.1066062] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 12/29/2022] Open
Abstract
The glucocorticoid (GC) steroid dexamethasone (Dex) is used as a supportive care co-medication for cancer patients undergoing standard care pemetrexed/platinum doublet chemotherapy. As trials for new cancer immunotherapy treatments increase in prevalence, it is important to track the immunological changes induced by co-medications commonly used in the clinic, but not specifically included in trial design or in pre-clinical models. Here, we document a number of Dex -induced immunological effects, including a large-scale lymphodepletive effect particularly affecting CD4+ T cells but also CD8+ T cells. The proportion of regulatory T cells within the CD4+ compartment did not change after Dex was administered, however a significant increase in proliferation and activation of regulatory T cells was observed. We also noted Dex -induced proportional changes in dendritic cell (DC) subtypes. We discuss these immunological effects in the context of chemoimmunotherapy strategies, and suggest a number of considerations to be taken into account when designing future studies where Dex and other GCs may be in use.
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Affiliation(s)
- Alistair M Cook
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; National Centre for Asbestos Related Diseases, Perth, WA, Australia
| | - Alison M McDonnell
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; National Centre for Asbestos Related Diseases, Perth, WA, Australia
| | - Richard A Lake
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; National Centre for Asbestos Related Diseases, Perth, WA, Australia
| | - Anna K Nowak
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia; National Centre for Asbestos Related Diseases, Perth, WA, Australia
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Creaney J, Ma S, Sneddon SA, Tourigny MR, Dick IM, Leon JS, Khong A, Fisher SA, Lake RA, Lesterhuis WJ, Nowak AK, Leary S, Watson MW, Robinson BW. Strong spontaneous tumor neoantigen responses induced by a natural human carcinogen. Oncoimmunology 2015; 4:e1011492. [PMID: 26140232 PMCID: PMC4485777 DOI: 10.1080/2162402x.2015.1011492] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/16/2015] [Accepted: 01/21/2015] [Indexed: 12/26/2022] Open
Abstract
A key to improving cancer immunotherapy will be the identification of tumor-specific "neoantigens" that arise from mutations and augment the resultant host immune response. In this study we identified single nucleotide variants (SNVs) by RNA sequencing of asbestos-induced murine mesothelioma cell lines AB1 and AB1-HA. Using the NetMHCpan 2.8 algorithm, the theoretical binding affinity of predicted peptides arising from high-confidence, exonic, non-synonymous SNVs was determined for the BALB/c strain. The immunoreactivity to 20 candidate mutation-carrying peptides of increased affinity and the corresponding wild-type peptides was determined using interferon-γ ELISPOT assays and lymphoid organs of non-manipulated tumor-bearing mice. A strong endogenous immune response was demonstrated to one of the candidate neoantigens, Uqcrc2; this response was detected in the draining lymph node and spleen. Antigen reactive cells were not detected in non-tumor bearing mice. The magnitude of the response to the Uqcrc2 neoantigen was similar to that of the strong influenza hemagglutinin antigen, a model tumor neoantigen. This work confirms that the approach of RNAseq plus peptide prediction and ELISPOT testing is sufficient to identify natural tumor neoantigens.
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Affiliation(s)
- Jenette Creaney
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia ; Australian Mesothelioma Tumour Bank; Sir Charles Gairdner Hospital ; Nedlands, Australia
| | - Shaokang Ma
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Sophie A Sneddon
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Michelle R Tourigny
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Ian M Dick
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia ; Australian Mesothelioma Tumour Bank; Sir Charles Gairdner Hospital ; Nedlands, Australia
| | - Justine S Leon
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia ; Australian Mesothelioma Tumour Bank; Sir Charles Gairdner Hospital ; Nedlands, Australia
| | - Andrea Khong
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia ; Department of Oncology; Sir Charles Gairdner Hospital ; Nedlands, Australia
| | - Shay Leary
- Institute for Immunology and Infectious Diseases; Murdoch University ; Murdoch, Australia
| | - Mark W Watson
- Institute for Immunology and Infectious Diseases; Murdoch University ; Murdoch, Australia
| | - Bruce W Robinson
- National Centre for Asbestos Related Diseases; School of Medicine and Pharmacology; University of Western Australia ; Nedlands, Australia ; Australian Mesothelioma Tumour Bank; Sir Charles Gairdner Hospital ; Nedlands, Australia ; Department of Respiratory Medicine; Sir Charles Gairdner Hospital ; Nedlands, Australia
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McDonnell AM, Joost Lesterhuis W, Khong A, Nowak AK, Lake RA, Currie AJ, Robinson BW. Restoration of defective cross-presentation in tumors by gemcitabine. Oncoimmunology 2015; 4:e1005501. [PMID: 26155402 PMCID: PMC4485774 DOI: 10.1080/2162402x.2015.1005501] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 12/29/2014] [Accepted: 12/30/2014] [Indexed: 02/03/2023] Open
Abstract
Tumor antigen cross-presentation by dendritic cells (DCs) to specific CD8+ T cells is central to antitumor immunity. Although highly efficient in draining lymph nodes, it is defective within the tumor site itself. Importantly, an immunogenic chemotherapy, gemcitabine, reverses this defect, allowing the potential re-stimulation of cytotoxic T lymphocytes within tumor sites.
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Affiliation(s)
- Alison M McDonnell
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia
| | - W Joost Lesterhuis
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia
| | - Andrea Khong
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia
| | - Anna K Nowak
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia ; Department of Medical Oncology; Sir Charles Gairdner Hospital ; Nedlands, WA, Australia
| | - Richard A Lake
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia
| | - Andrew J Currie
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; School of Veterinary and Life Sciences, Murdoch University , Murdoch, WA, Australia
| | - Bruce Ws Robinson
- School of Medicine and Pharmacology; The University of Western Australia ; Nedlands, WA, Australia ; National Centre for Asbestos Related Diseases ; Nedlands, WA, Australia
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Khong A, Cleaver AL, Fahmi Alatas M, Wylie BC, Connor T, Fisher SA, Broomfield S, Lesterhuis WJ, Currie AJ, Lake RA, Robinson BW. The efficacy of tumor debulking surgery is improved by adjuvant immunotherapy using imiquimod and anti-CD40. BMC Cancer 2014; 14:969. [PMID: 25518732 PMCID: PMC4320570 DOI: 10.1186/1471-2407-14-969] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 09/10/2014] [Accepted: 12/11/2014] [Indexed: 12/14/2022] Open
Abstract
Background Tumor debulking surgery followed by adjuvant chemotherapy or radiotherapy is a standard treatment for many solid malignancies. Although this approach can be effective, it often has limited success against recurrent or metastatic cancers and new multimodality approaches are needed. Adjuvant immunotherapy is another potentially effective approach. We therefore tested the efficacy of the TLR7 agonist imiquimod (IMQ) combined with agonistic anti-CD40 in an incomplete debulking model of malignant mesothelioma. Methods Established subcutaneous murine ABA-HA mesothelioma tumors in BALB/c mice were surgically debulked by 75% and treated with either: i) saline; ii) intratumoral IMQ; iii) systemic anti-CD40 antibody, or using a combination of IMQ and anti-CD40. Tumour growth and survival were monitored, and the role of anti-tumor CD4 and CD8 T cells in therapeutic responses was determined. Results The combination therapy of partial debulking surgery, IMQ and anti-CD40 significantly delayed tumor growth in a CD8 T cell dependent manner, and promoted tumor regression in 25% of animals with establishment of immunological memory. This response was associated with an increase in ICOS+ CD8 T cells and tumor-specific CTL activity in tumor draining lymph nodes along with an increase in ICOS+ CD8 T cells in responding tumours. Conclusions We show that the post-surgical environment can be significantly altered by the co-administration of adjuvant IMQ and anti-CD40, resulting in strong, systemic anti-tumor activity. Both adjuvants are available for clinical use/trial, hence this treatment regimen has clear translational potential.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Bruce W Robinson
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Perth, Western Australia.
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McDonnell AM, Lesterhuis WJ, Khong A, Nowak AK, Lake RA, Currie AJ, Robinson BWS. Tumor-infiltrating dendritic cells exhibit defective cross-presentation of tumor antigens, but is reversed by chemotherapy. Eur J Immunol 2014; 45:49-59. [PMID: 25316312 DOI: 10.1002/eji.201444722] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 09/19/2014] [Accepted: 10/10/2014] [Indexed: 11/11/2022]
Abstract
Cross-presentation defines the unique capacity of an APC to present exogenous Ag via MHC class I molecules to CD8(+) T cells. DCs are specialized cross-presenting cells and as such have a critical role in antitumor immunity. DCs are routinely found within the tumor microenvironment, but their capacity for endogenous or therapeutically enhanced cross-presentation is not well characterized. In this study, we examined the tumor and lymph node DC cross-presentation of a nominal marker tumor Ag, HA, expressed by the murine mesothelioma tumor AB1-HA. We found that tumors were infiltrated by predominantly CD11b(+) DCs with a semimature phenotype that could not cross-present tumor Ag, and therefore, were unable to induce tumor-specific T-cell activation or proliferation. Although tumor-infiltrating DCs were able to take up, process, and cross-present exogenous cell-bound and soluble Ags, this was significantly impaired relative to lymph node DCs. Importantly, however, systemic chemotherapy using gemcitabine reversed the defect in Ag cross-presentation of tumor DCs. These data demonstrate that DC cross-presentation within the tumor microenvironment is defective, but can be reversed by chemotherapy. These results have important implications for anticancer therapy, particularly regarding the use of immunotherapy in conjunction with cytotoxic chemotherapy.
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Affiliation(s)
- Alison M McDonnell
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, The University of Western Australia, Nedlands, WA, Australia
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Aston WJ, Fisher SA, Khong A, Mok C, Nowak AK, Lake RA, Lesterhuis WJ. Combining chemotherapy and checkpoint blockade in thoracic cancer: how to proceed? Lung Cancer Manag 2014. [DOI: 10.2217/lmt.14.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SUMMARY Given the impressive efficacy of immune checkpoint blockade in thoracic malignancies, and the recently discovered immune-stimulating properties of many cytotoxic drugs, a logical next step would be to combine these treatments. However, the rational design of clinical trials investigating these combinations is hampered by a lack of knowledge regarding the overall immunogenic effects of the different chemotherapeutics. Here, we give an overview of the field with regard to checkpoint blockade and the immunological effects of cytotoxic chemotherapeutics, with particular focus on preclinical and clinical studies investigating the combination of these two treatment modalities. We discuss the hurdles that need to be overcome in order to optimally exploit chemotherapy and immune checkpoint blockade combinations in thoracic cancers.
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Affiliation(s)
- Wayne J Aston
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Andrea Khong
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Clara Mok
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
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Abstract
The pathobiology-based approach to research and development has been the dominant paradigm for successful drug discovery over the last decades. We propose that the molecular and cellular events that govern a resolving, rather than an evolving, disease may reveal new druggable pathways.
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Affiliation(s)
- W Joost Lesterhuis
- School of Medicine and Pharmacology and National Centre for Asbestos Related Diseases, University of Western Australia, Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, Perth, Western Australia 6009, Australia
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Brown MD, van der Most R, Vivian JB, Lake RA, Larma I, Robinson BWS, Currie AJ. Loss of antigen cross-presentation after complete tumor resection is associated with the generation of protective tumor-specific CD8(+) T-cell immunity. Oncoimmunology 2014; 1:1084-1094. [PMID: 23170256 PMCID: PMC3494622 DOI: 10.4161/onci.20924] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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] [Indexed: 11/19/2022] Open
Abstract
An incomplete understanding on the effect of surgery on tumor-specific immunity continues to hamper efforts to combine surgery with immunotherapy in the clinic. Herein, we describe the impact of tumor resection on the tumor-specific T-cell response, showing that complete tumor resection is associated with (1) a decline in the amount of cross-presented tumor antigens, (2) a decline of cytolytic tumor-specific CD8(+) T cell activity, and (3) the development of systemic CD8(+) T cell-mediated protective immunity. Our findings are consistent with a model whereby tumor resection releases antitumor CD8(+) T cells from chronic antigen exposure, allowing a gradual differentiation toward functional antitumor memory T cells. This process depends on sentinel lymph nodes, as their removal at the time of surgery was associated with a strong negative effect on survival. We conclude that complete tumor resection provides a unique environment that boosts protective immunological memory and might provide a powerful platform for immunotherapy. Our findings also carry important implications for the design and timing of post-surgery immunotherapeutic regimens.
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Affiliation(s)
- Matthew D Brown
- Urological Research Centre/University Department of Surgery; Sir Charles Gairdner Hospital; Perth, WA
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Robinson C, Solin JN, Lee YCG, Lake RA, Lesterhuis WJ. Mouse models of mesothelioma: strengths, limitations and clinical translation. Lung Cancer Manag 2014. [DOI: 10.2217/lmt.14.27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Mouse models of cancer are invaluable for obtaining detailed knowledge about tumor development and for screening therapeutic and preventive approaches. Mesothelioma is an unusual cancer because the same carcinogen, asbestos, causes a similar disease in both humans and animals. Unlike most other cancers, murine mesothelioma can therefore be regarded as a disease homolog, rather than a model as such. However, because asbestos-induced cancer has low penetrance and a long lag time, most translational studies have utilized more efficient models such as tumor transplantation. In consequence, many promising results have not translated into positive findings in patients. Here, we describe the widely used murine mesothelioma models and critically discuss their relative advantages and disadvantages. We emphasize the use of the appropriate model for the specific research question and the need to use multiple models in order to obtain robust and translatable data.
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Affiliation(s)
- Cleo Robinson
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Jessica N Solin
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - YC Gary Lee
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
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Fisher SA, Cleaver A, Lakhiani DD, Khong A, Connor T, Wylie B, Lesterhuis WJ, Robinson BWS, Lake RA. Neoadjuvant anti-tumor vaccination prior to surgery enhances survival. J Transl Med 2014; 12:245. [PMID: 25186961 PMCID: PMC4156969 DOI: 10.1186/s12967-014-0245-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 03/13/2014] [Accepted: 08/26/2014] [Indexed: 02/06/2023] Open
Abstract
Background This study was conducted to determine if anti-tumor vaccination administered prior to partial debulking surgery could improve survival using a murine solid tumour model. Methods Tumor incidence and survival rates were compared in mice bearing subcutaneous AB1-HA mesothelioma tumors that received either sham surgery, debulking surgery or vaccination prior to debulking surgery. Additionally, mice were depleted of CD4 and/or CD8 T lymphocytes during vaccination to assess their involvement in vaccine induced anti-tumor immunity. Flow cytometry was performed to characterise changes in the proportion and activation status of immune cells associated with anti-tumor immunity. Results Neoadjuvant vaccination combined with debulking surgery resulted in decreased tumor burden, increased survival and generation of tumor-specific immunity compared to surgery alone. Depletion of CD8 T cells completely abrogated any vaccine induced anti-tumor immune response. Conversely, CD4 depletion enhanced CD8 T cell activation resulting in complete tumor regression in 70% of mice treated with combined surgery and vaccination therapy. Tumor free survival was associated with established immunological memory as defined by the induction of effector memory T cells and resistance to rechallenge with parental AB1 mesothelioma cells. Conclusions Neoadjuvant anti-cancer vaccination combined with partial debulking surgery induced CD8-dependent anti-tumor immunity that significantly delayed tumor outgrowth relative to surgery alone. Complete tumor eradication was observed when vaccination and surgery were performed in CD4 T cell depleted animals. This demonstrates that adjuvant immunotherapy can improve post-surgical survival following cancer debulking surgery and provides a scientific rational for clinical trials of such an approach.
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Affiliation(s)
- Scott A Fisher
- School of Medicine & Pharmacology, University of Western Australia, Perth, 4th Floor, G Block, Queen Elizabeth II Medical Centre, Perth 6009, WA, Australia.
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Robinson C, Alfonso H, Woo S, Walsh A, Olsen N, Musk AW, Robinson BWS, Nowak AK, Lake RA. Statins do not alter the incidence of mesothelioma in asbestos exposed mice or humans. PLoS One 2014; 9:e103025. [PMID: 25093718 PMCID: PMC4122392 DOI: 10.1371/journal.pone.0103025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 06/26/2014] [Indexed: 12/21/2022] Open
Abstract
Mesothelioma is principally caused by asbestos and may be preventable because there is a long latent period between exposure and disease development. The most at-risk are a relatively well-defined population who were exposed as a consequence of their occupations. Although preventative agents investigated so far have not been promising, discovery of such an agent would have a significant benefit world-wide on healthcare costs and personal suffering. Statins are widely used for management of hypercholesterolemia and cardiovascular risk; they can induce apoptosis in mesothelioma cells and epidemiological data has linked their use to a lower incidence of cancer. We hypothesised that statins would inhibit the development of asbestos-induced mesothelioma in mice and humans. An autochthonous murine model of asbestos-induced mesothelioma was used to test this by providing atorvastatin daily in the feed at 100 mg/kg, 200 mg/kg and 400 mg/kg. Continuous administration of atorvastatin did not alter the rate of disease development nor increase the length of time that mice survived. Latency to first symptoms of disease and disease progression were also unaffected. In a parallel study, the relationship between the use of statins and development of mesothelioma was investigated in asbestos-exposed humans. In a cohort of 1,738 asbestos exposed people living or working at a crocidolite mine site in Wittenoom, Western Australia, individuals who reported use of statins did not have a lower incidence of mesothelioma (HR = 1.01; 95% CI = 0.44–2.29, p = 0.99). Some individuals reported use of both statins and non-steroidal anti-inflammatory drugs or COX-2 inhibitors, and these people also did not have an altered risk of mesothelioma development (HR = 1.01; 95% CI = 0.61–1.67, p = 0.97). We conclude that statins do not moderate the rate of development of mesothelioma in either a mouse model or a human cohort exposed to asbestos.
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Affiliation(s)
- Cleo Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
- Anatomical Pathology, PathWest, Perth, Western Australia, Australia
- * E-mail:
| | - Helman Alfonso
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Samantha Woo
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
| | - Amy Walsh
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
| | - Nola Olsen
- Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, Perth, Western Australia, Australia
| | - Arthur W. Musk
- Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Bruce W. S. Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Nedlands, Perth, Western Australia, Australia
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Robinson C, Woo S, Nowak AK, Lake RA. Dietary vitamin D supplementation does not reduce the incidence or severity of asbestos-induced mesothelioma in a mouse model. Nutr Cancer 2014; 66:383-7. [PMID: 24564337 DOI: 10.1080/01635581.2013.878733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Epidemiological studies suggest that vitamin and mineral intake is associated with cancer incidence. A prevention strategy based on diet or dietary supplementation could have enormous benefit, both directly, by preventing disease, and indirectly by alleviating fear in millions of people worldwide who have been exposed to asbestos. We have previously shown that dietary supplementation with the antioxidants vitamins A, E, and selenium does not affect overall survival nor the time to progression of asbestos-induced mesothelioma in MexTAg mice. Here we have extended our analysis to vitamin D. We compared survival of asbestos-exposed MexTAg mice provided with diets that were deficient or supplemented with 4500 IU/kg vitamin D (cholecalciferol). Survival of supplemented mice was significantly shorter than mice given a standard AIN93 diet containing 1000 IU/kg cholecalciferol (median survival was 29 and 32.5 weeks respectively). However, mice deficient in vitamin D had the same rate of mesothelioma development as control mice. Neither the latency time from asbestos exposure to diagnosis nor disease progression after diagnosis were significantly different between mice on these diets. We conclude that vitamin D is unlikely to moderate the incidence of disease in asbestos-exposed populations or to ameliorate the pathology in patients with established mesothelioma.
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Affiliation(s)
- Cleo Robinson
- a National Centre for Asbestos Related Diseases , University of Western Australia , QEII Medical Centre, Nedlands , Perth , Australia
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Lesterhuis WJ, Salmons J, Nowak AK, Rozali EN, Khong A, Dick IM, Harken JA, Robinson BW, Lake RA. Synergistic effect of CTLA-4 blockade and cancer chemotherapy in the induction of anti-tumor immunity. PLoS One 2013. [PMID: 23626745 DOI: 10.1371/journal.pone.0061895.s009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Several chemotherapeutics exert immunomodulatory effects. One of these is the nucleoside analogue gemcitabine, which is widely used in patients with lung cancer, ovarian cancer, breast cancer, mesothelioma and several other types of cancer, but with limited efficacy. We hypothesized that the immunopotentiating effects of this drug are partly restrained by the inhibitory T cell molecule CTLA-4 and thus could be augmented by combining it with a blocking antibody against CTLA-4, which on its own has recently shown beneficial clinical effects in the treatment of patients with metastatic melanoma. Here we show, using two non-immunogenic murine tumor models, that treatment with gemcitabine chemotherapy in combination with CTLA-4 blockade results in the induction of a potent anti-tumor immune response. Depletion experiments demonstrated that both CD4(+) and CD8(+) T cells are required for optimal therapeutic effect. Mice treated with the combination exhibited tumor regression and long-term protective immunity. In addition, we show that the efficacy of the combination is moderated by the timing of administration of the two agents. Our results show that immune checkpoint blockade and cytotoxic chemotherapy can have a synergistic effect in the treatment of cancer. These results provide a basis to pursue combination therapies with anti-CTLA-4 and immunopotentiating chemotherapy and have important implications for future studies in cancer patients. Since both drugs are approved for use in patients our data can be immediately translated into clinical trials.
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Affiliation(s)
- W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia
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Lesterhuis WJ, Salmons J, Nowak AK, Rozali EN, Khong A, Dick IM, Harken JA, Robinson BW, Lake RA. Synergistic effect of CTLA-4 blockade and cancer chemotherapy in the induction of anti-tumor immunity. PLoS One 2013; 8:e61895. [PMID: 23626745 PMCID: PMC3633941 DOI: 10.1371/journal.pone.0061895] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/14/2013] [Indexed: 01/05/2023] Open
Abstract
Several chemotherapeutics exert immunomodulatory effects. One of these is the nucleoside analogue gemcitabine, which is widely used in patients with lung cancer, ovarian cancer, breast cancer, mesothelioma and several other types of cancer, but with limited efficacy. We hypothesized that the immunopotentiating effects of this drug are partly restrained by the inhibitory T cell molecule CTLA-4 and thus could be augmented by combining it with a blocking antibody against CTLA-4, which on its own has recently shown beneficial clinical effects in the treatment of patients with metastatic melanoma. Here we show, using two non-immunogenic murine tumor models, that treatment with gemcitabine chemotherapy in combination with CTLA-4 blockade results in the induction of a potent anti-tumor immune response. Depletion experiments demonstrated that both CD4+ and CD8+ T cells are required for optimal therapeutic effect. Mice treated with the combination exhibited tumor regression and long-term protective immunity. In addition, we show that the efficacy of the combination is moderated by the timing of administration of the two agents. Our results show that immune checkpoint blockade and cytotoxic chemotherapy can have a synergistic effect in the treatment of cancer. These results provide a basis to pursue combination therapies with anti-CTLA-4 and immunopotentiating chemotherapy and have important implications for future studies in cancer patients. Since both drugs are approved for use in patients our data can be immediately translated into clinical trials.
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Affiliation(s)
- W. Joost Lesterhuis
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Joanne Salmons
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
| | - Anna K. Nowak
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Esdy N. Rozali
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
| | - Andrea Khong
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
| | - Ian M. Dick
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
| | - Julie A. Harken
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
| | - Bruce W. Robinson
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases, The University of Western Australia, Crawley WA, Australia and Tumour Immunology Group, School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Western Australia, Australia
- * E-mail:
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McCoy MJ, Nowak AK, van der Most RG, Dick IM, Lake RA. Peripheral CD8(+) T cell proliferation is prognostic for patients with advanced thoracic malignancies. Cancer Immunol Immunother 2013; 62:529-39. [PMID: 23069871 PMCID: PMC11029143 DOI: 10.1007/s00262-012-1360-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 10/02/2012] [Indexed: 01/16/2023]
Abstract
There is a complex interplay between the immune system and a developing tumor that is manifest in the way that the balance of T cell subsets in the local tumor environment reflects clinical outcome. Tumor infiltration by CD8(+) T cells and regulatory T cells (Treg) is associated with improved and reduced survival, respectively, in many cancer types. However, little is known of the prognostic value of immunological parameters measured in peripheral blood. In this study, peripheral CD8(+) T cells and Treg from 43 patients with malignant mesothelioma or advanced non-small-cell lung cancer scheduled to commence palliative chemotherapy were assessed by flow cytometry and evaluated for association with patient survival. Patients had a higher proportion of peripheral Treg, proliferating CD8(+) T cells and CD8(+) T cells with an activated effector phenotype compared with age-matched healthy controls. Higher proportions of Treg and proliferating CD8(+) T cells were both associated with poor survival in univariate analyses (hazard ratio [HR] 3.81, 95 % CI 1.69-8.57; p < 0.01 and HR 2.86, 95 % CI 1.26-6.50; p < 0.05, respectively). CD8(+) T cell proliferation was independently predictive of reduced survival in multivariate analysis (HR 2.58, 95 % CI 1.01-6.61; p < 0.05). These findings suggest that peripheral CD8(+) T cell proliferation can be a useful prognostic marker in patients with thoracic malignancies planned for palliative chemotherapy.
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Affiliation(s)
- Melanie J McCoy
- School of Medicine and Pharmacology, The University of Western Australia, M503, 35 Stirling Highway, Crawley, WA, 6009, Australia.
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Abstract
Agonistic anti-CD40 antibody is a potent stimulator of anti-tumor immune responses due to its action on both immune and tumor cells. It has the ability to "precondition" dendritic cells, allowing them to prime effective cytotoxic T-cell responses. Thus, anti-CD40 antibody provides an ideal therapy for combination with traditional cancer treatments (i.e., chemotherapy, surgery) in order to elicit immune-mediated anti-tumor effects. This review summarizes the mechanisms of action of agonistic anti-CD40, the use of mouse models to investigate its effects and combinations with other therapies in vivo, and current clinical trials combining humanized anti-CD40 antibody with chemotherapy and/or other immunotherapies.
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Affiliation(s)
- Andrea Khong
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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Robinson C, Woo S, Walsh A, Nowak AK, Lake RA. The antioxidants vitamins A and E and selenium do not reduce the incidence of asbestos-induced disease in a mouse model of mesothelioma. Nutr Cancer 2012; 64:315-22. [PMID: 22292488 DOI: 10.1080/01635581.2012.649100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Epidemiological evidence indicates that supplementation with some dietary factors is associated with a lower incidence of cancer. An effective cancer prevention strategy for the millions of people worldwide who have been exposed to asbestos could have enormous benefit. We tested whether dietary supplementation of the antioxidants vitamin A, E, and selenium could alter the pattern of disease in the MexTAg transgenic mouse model, in which mice uniformly develop mesothelioma after asbestos exposure. We focused on antioxidants because one of the most widely accepted hypotheses for the mechanism by which asbestos fibers cause cancer proposes the involvement of reactive oxygen and nitrogen species. We compared the survival of MexTAg mice that had been inoculated with asbestos fed on diets supplemented with 250,000 IU/kg vitamin A (retinoic acid), or 1,000 mg/kg vitamin E (α-tocopherol acetate) or 3 mg/kg selenium, or both vitamin E and selenium concurrently and, additionally, diets deficient in each antioxidant. We found that neither the time to develop symptoms of disease nor overall survival times were altered by any of the diets. We conclude that the data do not support the notion that dietary antioxidants will moderate the rate of mesothelioma in asbestos-exposed populations.
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Affiliation(s)
- Cleo Robinson
- Tumour Immunology Group, National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
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